Pelvic traction is used to treat low back pain, hip and leg pain, and fractures or dislocations of the pelvis and lower spine. It works by applying gentle pulling forces to separate vertebrae and relieve pressure. There are two main methods - pelvic belt traction which uses a belt around the hips connected to weights, and pelvic binders which stabilize unstable pelvic fractures with a tight wrap. Proper positioning and application are important for pelvic traction and binders to be effective. Traction may need to be maintained for several days for benefits.

1. Presenter;
Ben Ka’K
PRNCPL. Ortho
N.DIP, Ortho Techno, KMTC Nbi.
HND Med Edu, KMTC Nbi
BSc Med Edu, MMU
TRACTION IN THE PELVIS

2. Pelvic traction
- Pelvic traction is used to alleviate low back pain, as well as hip and
leg pain associated with some lower back disorders.
- It can also be used to treat fractures, dislocations and long
duration muscle spasms and aid in achieving proper alignment of
the lower vertebrae.
Indications:
▪ Pathological and inflammatory diseases of the lumbar spine, e.g
prolapsed lumbar diseases and chronic lower back pain.
▪ Soft tissue contractures
▪ Displaced vertebral fractures.

3. 1. Pelvic Traction using Pelvic Belt
The patient wears a pelvic belt that fits snugly around his hips with
long straps on both sides that attach to a spreader bar and a rope and
pulley system with weights.
Because of the weight required for this type of traction, it is usually
necessary to off-set the pull of the weights to prevent the patient
from being slowly pulled down in the bed. This can best be achieved
with the use of a hospital bed, by simply elevating both the knees
and the head of the bed to place him in the Fowler Position.
(The Fowler Position looks like a semi-sitting position where the head
of the bed is elevated to 45 ° with the knees bent).

5. If the traction must be applied in a home bed, the hips and knees
should be flexed by placing a pillow or blanket-roll under the
knees. The foot of the home bed may also have to be elevated
slightly, using wooden blocks or bricks, to prevent you from sliding
down in the bed.
The proper flexing of the hips also contributes greatly to getting
the pull to the proper place and achieving better separation of the
vertebral discs.

7. COMMON ERRORS:
Some common errors in the application and use of pelvic traction
are:
▪ The tendency to wear the pelvic traction belt too high, around the
waist instead of much lower around the hips. The pull on the lower
spine must actually be applied to the pelvis. The top edge of the
pelvic traction belt should be just an inch or two above the
trochanter or hip bones. Wearing the belt too high can result in
receiving absolutely no benefit from the traction, since the belt
may actually then be above rather than below the affected
vertebrae. The traction could then be contributing to more pain
and your problem rather than to the relief of pain and the solution.

8. ▪ Failure to maintain the proper position with the knees and hips
adequately flexed.
▪ Not staying in the traction long enough. Unless otherwise, the
patient must remain essentially immobilized for a period of at
least several days. Getting in and out of the traction several times
a day will probably nullify any positive results and may actually
make the condition worse. Even when the patient achieves some
relief from the pain, the traction should be maintained.

9. 2. Pelvic binder:
This is used in initial management of an unstable pelvic fracture.
By applying a binder, stability is provided to the fracture.
- A simple bedsheet may also be used as a pelvic binder.
Correct application is vital for it to function properly and so the
BINDER SHOULD BE CENTRED AROUND THE GTs and not around the
patient’s waist.
Indications:
Unstable OPEN BOOK pelvic injury.

11. Application technique:
i. Place patient in supine position on stretcher.
ii. Palpate landmarks – the GT and ASIS (Anterior Superior Iliac
Spines).
iii. Roll the patient, to place the binder (or bedsheet) under the
patient, with help of additional people at the head and at the
legs.
iv. If bedsheet is used, place it as wide as possible over the GR &
ASIS.
v. Tie a very tight knot around the pelvis and add a 2nd knot.

13. vi. If a binder is used..
(a). Wrap binder around the patient.

14. (b). Make sure the binder is CENTRED ON THE GT!
(c). Pull the cords to tighten binder.

15. 3. Skin Traction
- Skin traction can also be used to tract, not only the pelvis but also
the SACRAL & LUMBAR spine.
- Applied on both lower limbs.
Indications:
▪ Pathological and inflammatory diseases of the lumbar spine, e.g
prolapsed lumbar diseases and chronic lower back pain.
▪ Soft tissue contractures
▪ Displaced vertebral fractures.
- Patient lies supine upon application, for weeks – depending on the
severity of injury.