reduction, immobilisation & alignment of fractures

relieve muscle spasm & pain

prevent further soft tissue damage

to promote rest

countertraction

weights, angles & pulleys

Adhesive and non adhesive skin traction - application of a pulling force directly on the patient's skin

Skeletal traction - attached directly to bone by use of wires and pins

Manual traction - applied with the hands to temporarily immobilise the injured part

Diagram of non-adhesive traction

obtain doctors orders for type of traction and weight required, determine wether intermittent or continuous

ensure weight is hanging free off the floor

maintain alignment of rope(s), pulley(s) & weight

rope should move freely over pulleys

ensure countertraction applied - elevate foot of bed or keep head of bed flat

skin traction needs to be removed at least once per day for hygiene & reapplication

manual traction ought to be used during removal

maintain traction weight when log rolling patients for PAC

skeletal traction requires daily pin site care and nightly according to ooze

use cue-tips & normal saline

observe for signs of infection

encourage patient to perform own pin site care

apply dressing if copious ooze

neurovascular checks Q4H

encourage deep breathing and coughing exercises and use of triflow

encourage bed exercises & physio

assessment of skin integrity each shift

pain assessment & management

maintain position of patient in bed - avoid external rotation of effected lower limb

prompt reporting of changes in neurovascular status, unrelieved pain, pin loosening / infection

traction only applied under doctor's orders

maintain integrity of traction

balances force of pull

monitor skin integrity especially bony prominences, at risk of developing pressure sores

removing weight interrupts traction force, can cause spasms

minimise risk of pin site infection & potential osteomyelitis

risk of neurovascular compromise due to pulling force on vessels & nerves

risk of respiratory compromise due to immobility, recumbent or semirecumbent position

may put pressure on peroneal nerve

ensure prompt intervention & treatment of complications