Traction in orthopaedics

1. AJIMSHA SHOUKATH
09M2386

2. WHAT IS TRACTION ?
Traction - the application of a force to
stretch certain parts of the body in a
specific direction

3. WHY DO WE NEED TRACTION ?
Reduction of fractures and dislocations and their
maintenance
For immobilizing a painful, inflamed joint
For the prevention of deformity, by counteracting
the muscle spasms associated with painful joint
conditions.
For correction of soft tissue contractures by
stretching them out

4. TRACTION
 Controls pain.
 Reduces fracture.
 Maintain reduction.
 Prevents & corrects deformity.

5. TRACTION
Based on principle
Fixed traction
Sliding traction

6. FIXED TRACTION
Traction is applied to the leg against a fixed point of
counter pressure.
Fixed traction in Thomas’s splint
Roger Anderson well-leg traction
Halo-Pelvic Traction

7. THOMAS SPLINT
Used for # shaft of femur
Counter traction provided by ischeal Tuberosity

8. SLIDING TRACTION
When the weight of all or part of the body,
acting under the influence of gravity, is utilized
to provide counter-traction.

9. TYPES OF TRACTION ON
APPLICATION
Skin traction
Adhesive
Non – adhesive
Skeletal Traction

10. SKIN TRACTION

11. SKIN TRACTION
Traction force is applied over a large area of
skin
Applied over limb distal to fracture site
Anteromedial and posterolateral part should
be covered with cotton.

12. SKIN TRACTION
Adhesive skin traction:
Maximum weight 6.7 kg
Non-adhesive skin traction
Maximum weight should not exceed 4.5 kg
Used in thin and atrophic skin,
skin sensitive to adhesive strapping.

13. COMMON SKIN TRACTIONS
Buck’s Traction
Hamilton Russel Traction
Tulloch Brown Traction
Gallow’s or Brayant’s Traction
Modified Brayan’s Traction

14. Buck’s Traction
Often used
preoperatively for
femoral fractures
Can use tape
No more than 5 kgs

15. HAMILTON RUSSEL TRACTION
Below knee skin traction is applied
A broad soft sling is placed under the knee

16. BRYANT’S (GALLOW’S )
TRACTION
the treatment of fracture shaft femur in
children up to age of 2 yrs.
Weight of child should be less than 15- 18 kg
Above knee skin traction is applied bilaterally
Tie the traction to the over head
beam.

17. MODIFIED BRYANT’S TRACTION
Sometimes used as a initial
management of developmental
dysplasia of hip (1 YR)
After 5 days of Bryant’s traction,
abduction of both hips is begun
increased by about 10 degree
alternate days.
By three weeks hips should be fully
abducted.

18. SKIN TRACTION
COMPLICATIONS Of Adhesive Skin Traction :
Allergic reactions to adhesives.
Excoriation of skin.
Pressure sores over bony prominences and
tendoachillis.
Common peroneal nerve palsy.

19. SKELETAL TRACTION

20. SKELETAL TRACTION
pin or wire
more frequently used in lower limb fractures
Should be reserved for those cases in which
skin traction is insufficient.
Generally used when more weight is needed
to give traction.
To treat fractures conservatively.

21. SKELETAL TRACTION
SITES
Upper tibial
Lower femoral
Lower tibial
Calcaneus
Olecrenon
Metacarpel

22. SOME SKELETAL TRACTIONS
Lateral or Upper Femoral Traction
Nintey / Nintey traction
Olecrenone traction
Perkin’s Traction

23. LATERAL or UPPER FEMORAL
TRACTION
For the management of central
fracture dislocation of the hip
about 2.5 cm from most prominent
part of greater trochanter mid way
between ant. And post. surface of
femur
threaded screw
Attach weight upto 9 kgs
Traction to continued for about 4-6 wks

24. NINETY / NINETY TRACTION
Used for sub trochanteric fractures and those
in the proximal third of the shaft of the femur
Management of fractures with posterior
wound is easier
Traction is given through lower femoral pin,
which is more efficient, or by upper tibial pin.

26. SKELETAL TRACTION
COMPLICATIONS
Infection
Cut out
Distraction at fracture site
Nerve Injury

27. CERVICAL TRACTIONS
SKIN TRACTION Head Halter traction
SKELETAL TRACTION
Crutchfield tongs
Cone or Barton tongs

28. Head Halter traction
Simple type cervical
traction
Management of neck pain
Weight should not exceed
3 kg initially
Can only be used a few
hours at a time
Head end should be
elevated to give counter
traction

29. CERVICAL TRACTIONS
LEVELLEVEL MAX. WTMAX. WT
C2C2 4.5-5.4 Kg 4.5-5.4 Kg
C3C3 4.5-6.7Kg 4.5-6.7Kg
C4C4 6.7-9.0Kg 6.7-9.0Kg
C5C5 9.0-11.3Kg 9.0-11.3Kg
C6C6 9.0-13.5Kg 9.0-13.5Kg
C7C7 11.3-15.8Kg 11.3-15.8Kg