Mechanical traction exerts a pulling force on a part of the bodyusually the spine, pelvis, or long bones of the arms and legs. It can be used to reduce fractures, treat dislocations, correct or prevent deformities, improve or correct contractures, or decrease muscle spasms. It is not used as frequently as it was in the past because of improved surgical interventions and decreases in length of hospital stays.
Depending on the injury or condition, an orthopedist may order either skin or skeletal traction. Skin traction, applied directly to the skin and thus indirectly to the bone, is ordered when a light, temporary, or noncontinuous pulling force is required and is more commonly used in pediatrics. Contraindications include a severe injury with open wounds, an allergy to tape or other skin traction equipment, circulatory disturbances, dermatitis, and varicose veins.
In skeletal traction, an orthopedist inserts a pin or wire through the bone and attaches the traction equipment to the pin or wire to exert a direct, constant, longitudinal pulling force. Indications include fractures of the tibia, femur, and humerus where surgery is either delayed or contraindicated. Infections, such as osteomyelitis, contraindicate skeletal traction. (See Complications of traction.)
An orthopedic assistant usually is responsible for setting up the traction frame. After the patient is placed in the ordered type of traction, the nurse is responsible for preventing complications from immobility; for routinely inspecting the equipment; for adding traction weights as ordered; and, in patients with skeletal traction, for monitoring pin insertion sites for signs of infection. (See Comparing types of traction.)
Overhead frame: There are three basic frames: the claw-type frame, the intravenous (I.V.)-type frame, and the Balkan frame. All frames consist of bars and clamps to form an overhead frame. The physician will order the type of frame desired, and either the physician or the orthopedic assistant will assemble.
For all frame types: trapeze with clamp wall bumper or roller.
For skeletal traction care: sterile cotton-tipped applicators prescribed antiseptic solution sterile gauze pads povidone-iodine solution * optional: antimicrobial ointment.
Arrange with central supply or the appropriate department to have traction equipment transported to the patient's room on a traction cart. If appropriate, gather equipment for pin site care at the patient's bedside. Pin site care protocols may vary with each hospital or physician.