Understanding and Maintaining Traction

• Traction is the application of a pulling force to a part of the body.

• Traction is used to:

  • Minimize muscle spasms
  • Reduce, align, and immobilize fractures
  • Reduce deformity
  • Increase space between opposing forces

• Traction can be applied to the skin or directly to the bone.

• The nurse's responsibilities include:

  • Maintaining effective traction
  • Maintaining proper body alignment
  • Providing pin site care
  • Monitoring for complications
  • Providing psychological support

Maintaining Effective Traction

• Ensure that the weights hang freely and do not touch the floor.
• Ensure that the ropes move freely over pulleys.
• Check the ropes for fraying.
• Maintain the prescribed weight.
• Ensure that the patient is in proper alignment.
• Ensure that the patient's bed is in the correct position.
• Encourage active range of motion exercises.
• Provide pin site care as prescribed.

Skin Traction

• With skin traction, pulling force is applied to the skin and soft tissues.

• Types of skin traction include:

  • Buck’s traction (straight traction)
  • Cervical traction
  • Russell’s traction
  • Bryant’s traction

• Skin traction is used for short-term immobilization or to correct minor deformities.

• Ensure proper application of traction.

• Inspect the skin for irritation and breakdown.

• Provide skin care every 2 hours.

• Pad bony prominences.

Skeletal Traction

• With skeletal traction, pins or wires are surgically inserted through the bone.

• Skeletal traction is used for prolonged periods and when a large amount of weight is needed.

• Types of skeletal traction include:

  • Balanced suspension traction
  • Halo traction

• Maintain proper body alignment.

• Provide pin site care as prescribed (usually with chlorhexidine).

• Monitor for signs of infection.

• Monitor neurovascular status.

Pin Site Care

• Assess pin sites every shift for signs of infection.
• Clean pin sites as prescribed (usually with chlorhexidine).
• Sterile technique may be required.
• Observe for:
  • Redness
  • Swelling
  • Drainage
  • Pain
• Teach the patient to avoid touching the pin sites.

Potential Complications

• Skin breakdown
• Nerve damage
• Circulatory impairment
• Infection
• Pulmonary complications
• Thromboembolism
• Constipation

Neurovascular Assessment

• Assess and document neurovascular status every 1-4 hours.
• Assess for:
  • Pain
  • Pallor
  • Pulselessness
  • Paresthesia
  • Paralysis
• Report any changes to the physician immediately.

Nursing Interventions

• Provide meticulous skin care to prevent skin breakdown.
• Encourage coughing and deep breathing to prevent pulmonary complications.
• Encourage active range of motion exercises to prevent thromboembolism.
• Provide adequate hydration to prevent constipation.
• Provide psychological support to the patient and family.
• Teach the patient about the purpose of traction.
• Teach the patient about proper body alignment.
• Teach the patient about pin site care.
• Teach the patient about potential complications.
• Encourage the patient to participate in their care.

Patient Education

• Explain the purpose of traction.
• Explain the importance of maintaining proper body alignment.
• Teach the patient how to use a trapeze.
• Teach the patient about pin site care.
• Teach the patient about potential complications.
• Encourage the patient to report any pain or discomfort.
• Teach the patient about medications.
• Teach the patient about activity restrictions.
• Teach the patient about follow-up appointments.
• Home safety, if applicable