1. Topic: Traction
By:
Mr Murdin b Amit
Lecturer cum Coordinator
Diploma In Medical Assistant Program
Faculty of Allied Health Science
University College Shahputra, Kuantan
Pahang

2. Learning objectives:
1. Define traction.
2. State the purpose and indications of traction
3. State the type of traction
4. Describe the application of traction procedure
5. Explain the attention that needs to be done after
the application of traction (circulation / effectiveness
of traction)
6. Describe the advice that should be given to
patients after applications of traction

3. Introduction
Traction is one of the methods used in the
treatment of fractures. Where, a pulling is
used for fighting natural tension or muscle
tissue that surrounds the broken bone.
A high force apply by using weights, ropes
or pulleys needed to ensure that the broken
bone is in the right position (right) as the
original in the early stages of healing.
Example, fracture of femur bone.

4. The purpose of traction:
1. Reduction - To maintain the position of the
bones are in a real position to prevent
dislocation or defect.
2. Correct small defects
3. Reduce / relieve pain
4. Ensure immobilization of infections that
can impair the bone joints
5. Prevent broken bones and joints from
being deformed
6. Control the movement of the injured leg
7. To reduced muscle spasm

5. METHODS IN TRACTION
1. Skin traction
2. Skeleton traction

6. 1. SKIN TRACTION
- is a pulling with a supporter who affixed directly to the
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skin in the area of fracture involved
- It is intended to draw a broken bone without making
the skin incision. But it involves the soft tissues beneath
the skin are involved. Thus if we impose excessive pull it
will damage or cause disruption in other tissues.
- The maximum weight that is commonly used is not
more than 95 1bs (6.7kg) in accordance with conditions
- Through this fact we are able to say, that skin traction is
more suitable for use in children or as a temporary
procedure in adult patients while waiting for the proper
treatment

7. • How to use / use skin traction
a. Area for installation splint
b. Installation of felt strip
c. The area has been fitted with splint
d. Bandaged splint used to hold back from
moving

8. Contra indications in the use of skin
traction
1. Patients may lose skin burns or gets
necessitates abrasive / flails
2. There are a lot of cuts or wounds in
3. There is a disturbance in blood
circulation such as varicose vein or
gangren
4. Patients have dermatitis

9. Complications skin traction
1. Erythema
2. Allergic
3. Muscular atrophy
4. Paralysis
5. Foot drop
6. Pressure afternoon
7. Edema
8. Cause skin in the affected area burst
(excoriation) or torn

10. Skin traction purposes
1. Reduction - fracture, dislocation, and
maintaining the alignment
2. Reduced muscular spasm
3. Relieve pain
4. Rectify, reduce or prevent deformity
5. Maintaining Immobilization (swelling,
pain, arthritis, and inflammation)
6. Correct defects

11. 2. Skeletal TRACTION
- It is pull and involving bone as a supporter; where a pin
or wire implanted in the bone, and serves as a tool to pull
- When this pin or wire through the bone, it looks very
painful but otherwise it is more comfortable when
compared with using skin traction
- It also member greater traction and precision to place
fracturing
- It is commonly used in fracturing lower limb, upper limb
and a common place for tight pin or wire is like calcaneum
bone, tibia bone, skull, pelvic bone, and a few other places
- Pin type that is commonly used is the Steinman pin, and
Threaded pin
- The most commonly used type of wire is wire Kirschner

12. Complications skeletal traction
1. Infection were
2. Mal union
3. Deformities
4. If the pin walked or wire can cause:
a. As a result of the injury to the pin on the side in
happiness
b. Movements become difficult
c. Difficult to install splint
d. Attraction may not equal
5. To attract the fracture requires quite a lot of
weights
6. Ligament will be damaged
7. Can cause pressure sores

13. USE COMMON TYPE TRACTION
1. FIXED TRACTION
a. The principle used is that every appeal
made in this way does not require any
weights, but instead it against the patient's
body found on
b. There are two ways that can be used with
this type of Pull, namely: -
i. Fixed traction with splint
ii. Fixed traction that changed the gravity

14. Fixed traction with splint
- It is a simple method of attraction, which
involved members placed over splint, usually
using Thomas Splint
- The force produced pulling, not supported by
the weight, but otherwise produced by binding
traction splint ends at the end of the patient bed
and raise a little foot patient bed
- This attraction will be changed from week to
week based on the impression produced by the x-
ray by way of further shortening the bond at the
end of the patient bed

15. Fixed traction using gravity
The basic principle used in this way is to
uphold and suspend the limb involved. It is
called the Gallows traction, which is usually
done on children under the age of 3 years. It
can be used for femur fracture and the child
would be in this position for 2 to 3 weeks
according to the fracture and age

16. • 2. Sliding OR BALANCED TRACTION
- Pull used in this method is assisted by weight,
where the weight against the weight of the
patients had imposed upon him; however, the
amount of weight used is equal to the weight of
the patient.
- Pull this type can be used for any type of fracture
and principles used usually is the same.
- Pull the privilege of use is easier to move
patients and allow movement of bed involved
when converting Pull into a desired position

17. Traction sliding type commonly used are:
a. Simple traction
i. Pull this kind are usually followed by the
method of skin traction
ii. It can be used in any situation
iii. It is more appropriate and effective to
fracture at the waist and covers the portion of
the spine. Examples of such patients get
prolapsed inter vertebral disc (PID).

18. b. Longitudinal traction
i. commonly used for fracture femur
ii. It is used in conjunction Thomas Splint
which acts as a fixed traction
iii. Pull the used is skeletal traction
method, where the pins to be mounted on
the tibia bone and feet act as a supporter
of Thomas Splint

19. c. Bohler-Braun Traction (BBT)
i. Pull used with this type usually used for
tibia fracture and thighs
ii. The legs supported in a straight line on
the sling is tensioned across a frame

20. d. Hamilton - Russell Traction (HRT)
i. Pull this type usually used for femur fracture, involving the buttocks and
lower limbs
ii. Can be used for both sides of the fracture or one leg only
iii. It is usually used in conjunction with a skin extension
iv. Pull in, it uses 4 seed pulley. Where the only piece of this pulley is
placed at the top and vertical tubercle on the tibia bone.
v. Two other seeds were placed at the foot of installed crossed patient bed.
Meanwhile, another piece pulley mounted at the foot of a patient who was
tied with skin traction
vi. Ropes of swings located at the knee would pass pulley at the top and the
next is wheel - pulley on the feet bed patients.
vii. When the Pull is, the cradle of the patient in question would lift the
knee forward.

21. e. Bryant traction
i. Used in the treatment of femur fracture on
children under 6 years old
ii. Commonly used where it involves
fracturing on both sides of the
iii. To determine the position of the child is
always stable, a special jacket fitted over the
child and fastened to a frame (Brad Ford
Frame), where children will be lying on this
frame until healed.

22. f. Dunlop traction
i. Methods used for fracturing treatment
involving clavicle bone, the supracondylar
fracture, humerus bone and the head or
neck of the humerus bone.

23. g. Pelvic traction
i. Lumber used in the treatment of
prolapsed inter vertebral disc (PLIVD)
ii. Where, kidney patients will be paired
with a wide belt made of cloth or leather
knaves, and it must be installed tightly.

24. h. Skull traction
i. Used in clavicle fractures due to bone or clavicle
slipped from its original position.
ii. Available in two ways, namely by using tongs
or Vinke Crutchfield tongs
i. Pelvic sling
i. Used in pelvic fracture is not severe, as there is a
distance in the pubic or ischial hemp

25. Factors to determining Pull Weighting
1. Place fracturing
2. Age - old, young, children
3. Weight
4. Patient's muscle strength
5. Breadth of patient muscle injury
6. Heavy weight 10% of the patient's body weight
7. If necessary, add weight - total is 0.46kg (1lb) to
2.5cm (1 inch) height of the edge of the bed was
elevated
8. Traction on skull 7 to 12 kg

26. • Special care to Pull skeletal:
Pull the skull
- Allow a small sand bag under the neck
- Pull the tool and check the entry pin to
detect any signs of infection such as
- Redness and discharge
- Tighten the tools pull is loose
- Make sure the patient is not interested in a
bed or pulled down on the bed by the weight

27. • Pull the skeletal
- Installed on as fumer fracture, humerus,
tibia, fibula and cervical spine
- Practice aseptic technique during the
installation pin or wire and during
dressing place a pin or wire entry
- Make sure the weight is 7 -12 kg

28. Pull the skin
- Do the custody of the Pull skin if installed
together with Pull skeletal
- Do the custody of the pin or wire
- Observation of color discharge, wound dressing
situation-always close with 'dry dressing' or have
the spray
- Value-odor, signs of infection and present 'crust
'place pin entry
- Avoid pressure sores place in ischial tuberositi,
popliteal space,

29. • Achilles tendon and heel
- Maintain position foot - plantar dorsi, spin in,
spin out, to support the footprint and flexible
movement
Patients
- Care to do the following: -
o mental state
o physiotherapy
o nutrition and fluids
o hygiene

30. • Management
- Physiotherapy, muscle atrophy, DVT
- Care of skin-pressure pm
- A wound care
- Care of bowel-aperients
- Diet
- Medications

31. Q&A
Thank You
For Your Attention