Traction: Dr.K.Arvind Natarajan 1 Year MS Ortho

TRACTION
Dr.K.Arvind Natarajan
1st Year MS Ortho
INTRODUCTION
 Inflammation - fracture – Muscle spasm-
Deformity.
Traction
 Overcomes deforming force – reduces
fracture.
 Pain relief.
 Aids healing of soft tissue and bone.
METHODS
Satisfactory grip must be obtained on a part
of the body.
Limbs
 Skin Traction
 Skeletal Traction
SKIN TRACTION
PRINCIPLES
 Large area of skin.
 Traction force- distal to fracture site.
 Maximum weight- 6.7 kg.
TYPES
 Adhesive skin traction
 Non-adhesive skin traction
ADHESIVE SKIN TRACTION
 Acrylic or zinc oxide.

 More secure – no need for frequent re-
applications.
 Disadvantage- allergy
NON-ADHESIVE TRACTION
 Latex foam rubber laminated on a strong cloth.

 Can be used on thin atrophic skin or if they if
there is allergy to adhesive traction.
 Disadvantage- less secure- need daily re-
applications.
METHOD OF APPLICATION
 Shave the limb (adhesive)
 Protect bony prominences with strip of

felt (malleoli, ulnar head, radial styloid
process)
 Start distal to ankle/wrist- leave a loop

projecting of about 2 inches beyond distal
end- free movement of foot/fingers.
METHOD OF APPLICATION
 Strapping anteriorly on the medial side
and posteriorly on the lateral side- to
encourage medial rotation of the limb.
 Crepe or elasticated bandage applied

firmly over the strapping.
 Attach traction weight using spreader and

cords.
CONTRA-INDICATIONS
 Abrasions/ Lacerations
 Varicose veins or impending gangrene.
 Dermatitis.
 Marked shortening – traction weight
required will be greater.
COMPLICATIONS
 Allergy
 Excoriation of skin.
 Pressure sores.
 Common peroneal nerve palsy- pressure
near head of fibula.
SKELETAL TRACTION
 In cases where skin traction is contra-

indicated- abrasion, laceration, shortening.
 Metal pin or wire is driven through the

bone – traction force is applied directly
on the skeleton.
DEVICES
 STEINMANN PIN- stainless steel pin of

4-6mm in diameter- attached to Bohler
stirrup.
DEVICES
 Denham pin- similar to steinman with a

raised threaded length the end- prevent
sliding – suitable for cancellous bone or in
osteoporotic bone.
DEVICES
 Kirschner wire- pulled taut with

Kirschner strainer- cuts out of bone if
heavy traction is applied- upper limb.
SITES- OLECRANON
 Olecranon- 3cm distal to the tip of the

olecrenon.
 K-wire- medial to lateral- at right angles
to longitudinal axis of the ulna.
SITES- 2ND & 3RD METACARPELS
 2-2.5 cm proximal to distal end of second

metacarpel.
 K-wire -Traverses 2nd & 3rd metacarpel at right
angles to the longitudinal axis of radius.
SITES- UPPER END OF FEMUR
 Lateral surface of femur – 2.5 cm below

the greater trochanter.
 Threaded cancellous screw.
SITES- LOWER END OF FEMUR
 Line backwards at the level of upper pole of

patella.
 Another line below upwards anterior to the head
of fibula.
 Steinman pin at point of intersection
SITES- UPPER END OF TIBIA
 2cm below and behind the tubercle of

tibia.
 Steinman pin- lateral to medial.
SITES- LOWER END OF TIBIA
 2 inches above the ankle joint midway

between the anterior & posterior
borders of tibia.
SITES- CALCANEUM
 2 cm below and behind the lateral

malleolus
COMPLICATIONS
 Osteomyelitis
 Incorrect placement- failure of traction.
 Distraction at fracture site – very large
traction force.
 Ligamentous damage.
 Damage to epiphyseal growth plate in
children.
 Depressed scars- prevented by pinching pin
track during removal of pin to rupture
fibrous tissue b/n skin and periosteum.
COUNTER-TRACTION
COUNTER-TRACTION
 Traction force can overcome muscle
spasm only if another force is applied at
the same time acting in the opposite
direction.
 Prevents the whole body from being

pulled in the direction of the traction
force.
METHODS
 Fixed traction- counter-traction
through an appliance which obtains
purchase on a part of the body.
 Sliding traction – gravity used to

provide counter-traction by tilting the bed
so patient slides in the opposite direction
of traction force.
FIXED TRACTION
 Method of counter-traction by using a
device to apply counter force a fixed
point on the body – proximal to the
attachment of the muscle in spasm.
1. Thomas splint.
2. Roger Anderson well leg traction.
THOMAS SPLINT
 Padded metal ring – inner & outer side bars- 120

degress.
 Outer side bar angled out 2cm- greater
trochanter.
 Distal end – side bars joined in the form of a W.
ROGER ANDERSON WELL LEG
TRACTION
 Originally used in management of fractures of

pelvis, femur and tibia.
 Skeletal traction applied to injured leg while the
well leg was employed for counter-traction.
ABDUCTION/ADDUCTION
CORRECTION

Traction: Dr.K.Arvind Natarajan 1 Year MS Ortho

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Traction: Dr.K.Arvind Natarajan 1 Year MS Ortho

Uploaded by

Copyright:

Available Formats

TRACTION

 Acrylic or zinc oxide.

 Latex foam rubber laminated on a strong cloth.

 Protect bony prominences with strip of

 Start distal to ankle/wrist- leave a loop

 Crepe or elasticated bandage applied

 Attach traction weight using spreader and

 In cases where skin traction is contra-

 Metal pin or wire is driven through the

 STEINMANN PIN- stainless steel pin of

 Denham pin- similar to steinman with a

 Kirschner wire- pulled taut with

 Olecranon- 3cm distal to the tip of the

 2-2.5 cm proximal to distal end of second

 Lateral surface of femur – 2.5 cm below

 Line backwards at the level of upper pole of

 2cm below and behind the tubercle of

 2 inches above the ankle joint midway

 2 cm below and behind the lateral

 Prevents the whole body from being

 Sliding traction – gravity used to

 Padded metal ring – inner & outer side bars- 120

 Originally used in management of fractures of

You might also like