This document discusses traction, which uses weights and pulleys to gently pull broken or dislocated body parts back into position. It defines traction, outlines its purposes and principles, and describes types like skin and skeletal traction. Potential complications are noted. Nursing management focuses on skin integrity, traction care, observations, pain management, and activity as tolerated.

1. SYED JUNAID NASEER
B.Sc. Nursing 2022
syedj5033@gmail.com

2.  outline
 INTRODUCTION
 DEFINITION
 PRINCIPLES
 PURPOSES
 TYPES OF TRACTION
 COMMONLY USED TRACTIONS
 COMPLICATIONS
 NURSING MANAGEMENT OF PATIENT WITH TRACTION

3. • Traction is a technique for realigning a broken bone
or dislocated part of the body. It uses weights,
pulleys, and ropes to gently put pressure on and pull
a bone or injured body part back into the right
position.
• The use of traction dates as far back as 3000 years
(Ancient Egyptians).
• Used extensively in civil war for fractured femurs.

4. definition
• Traction can be defined as the applying a pulling
force for medical purpose to reduce fractures,
maintain bone alignment ,relieve pain , or to prevent
spinal injury.

5. 1. The traction applied must produce a
pulling effect on the body in the
longitudinal direction.
2. There should be a counter traction to
achieve effective traction.
3. A precise amount of weight must be
applied.
4. Weights applied must be hanging freely

6. •To stabilize and realign a broken bone or dislocated part of
the body (e.g., shoulder ).
•Helps a fractured bone to get back into a normal position.
•Temporarily relieves pain before surgery
•Eliminates muscle spasms and constricted joints, muscles
and tendons.
•Relieves pressure on nerves,(especially spinal nerves).
• Treats bone deformities.

7.  TYPEs OF TRACTION
Based on mechanism:-
1. Fixed traction
2. Sliding traction
Based on method of application:-
1. Skin traction
2. Skeletal traction

8. Based on mechanism:-
1.Fixed traction:- In this type of traction a pull is generated between
two fixed points .Or counter traction is provided by a part of the body
itself.
2. Sliding traction :- the pull is exerted by a pull between hanging
weights and the patient's own body weight
.
The fundamental principle of this type of traction is to string the
patient up by the injured limb and leave them hanging until the bone
has joined.
Gallows traction for a child under the age of 3 with fractured femur is
a good example of this. Children tolerate the position surprisingly
well for the 2–3 weeks necessary for the fracture to unite at this age
The weight of the child should be enough to hold the limb out to
length. A hand can be slipped between the buttocks and sheet.

9. Based on the method of application:-
1. Skin traction:- Skin traction is applied by strapping
the patient’s affected lower limb and attaching weights.
2. Skeletal traction:-Skeletal traction involves placing
a pin, wire, or screw in the fractured bone.
After one of these devices has been inserted, weights
are attached to it so the bone can be pulled into the
correct position.
This type of surgery may be done using a general,
spinal, or local anesthesia.

10.  Commonly used tractions
 Bryant's traction.
 Buck's traction, involving skin traction
 Dunlop's traction – humeral fractures in children.
 Russell's traction etc………………..

15.  complications
 Infection. In skeletal traction, a metal pin is inserted
into your bone. ...
 Pressure sores. ...
 Nerve damage. ...
 Misalignment of the bone or joint. ...
 Stiff joints. ...
 Wire malfunction. ...
 Deep vein thrombosis (DVT).

16.  Nursing management of patient with traction
Maintain skin integrity
 Patient’s legs, heels, elbows and buttocks may
develop pressure areas due to remaining in the
same position and the pressure of the bandages.
 Position a rolled-up towel/pillow under the heel to
relieve potential pressure.
 Encourage the patient to reposition themselves or
complete pressure area care four hourly.

17. Continue……
 Remove the foam stirrup and bandage once per
shift, to relieve potential pressure and observe the
condition of the patient’s skin. At this time, while the
bandages are down you can moisturize the skin.
 Minimize the sheet's wrinkles and aim to keep dry to
reduce potential skin damage.
 Assess and document the condition of skin
throughout care in the progress notes and care plan.
 Ensure that the pressure injury prevention score and
plan is assessed every shift and documented

18. Continue….
Traction care
 Ensure that the traction weight bag is hanging
freely, this bag must NOT rest on the bed or the
floor.
 If the rope becomes frayed replace immediately.
 The rope must be in the pulley tracks at all
times, and should be vertically aligned with the
patients’ leg, not on an angle.
 Ensure the bandages are free from wrinkles
which may cause pressure injury.

19. Continue…
 Observations
 Check the patient’s neurovascular observations hourly and
document in flow sheets.
 If the bandage is too tight it can cause blood circulation to be
slowed. If this is the case the bandage will need to be
removed and reapplied maintaining circulation.
 Monitoring of swelling of the femur should also occur to
observe for compartment syndrome.
 If neurovascular compromise is detected, remove the bandage
and reapply bandage. If circulation does not improve notify the
orthopedic team.

20. Continue….
Pain assessment and management
 Regular hourly assessment of pain is essential to ensure that the
correct analgesia is administered to manage the patient’s pain.
 Paracetamol, diazepam and oxycodone should all be charted and
administered as necessary.
 Pre-emptive analgesia ensures that the patient’s pain is sufficiently
managed and should be considered prior to pressure area care.
 Assess and document outcomes of all employed pain management
strategies.

21. Continue..
Activity
 The patient can sit up in bed and participate in quiet
activities such as craft, board games and watching TV.
Child Life Therapy will be beneficial for patients in
traction long term.
 Non-pharmacological distraction and activity will
improve patient comfort.
 The patient can move in bed as tolerated for hygiene to
be completed.
 Patients who are in traction for several weeks should
have a referral to the education department/kinder.