Principles of Traction methods

Skin versus Skeletal Traction

The skin can only take about 5kg traction in an adult. If more than this force is required to obtain on maintain a reduction Skeletal traction must be used. Avoid skeletal traction in children - growth plates can easily be damaged by skeletal pins.

Indications for Skin Traction
• Children
• Temporary traction - only a few days e.g. Preoperative
• Small force required to maintain reduction <5 kg

Fragile or delicate skin

In the elderly or patients with allergy to Elastoplast (Zinc)
hypoallergenic skin traction bandages are available.

Contraindications to Skin Traction
• Force required > 5kg
• Skin damage or sepsis in area

• Adults requiring > 5kg traction
• Skin damage requiring dressings
• Long term

Counter Traction

Any force needs an opposing force. If traction pulls a limb distally the patient will slide downwards towards the pulley, and the traction will not be effective. Provide an opposing force by raising the foot of the bed on blocks. By sloping the bed in the other direction the tendency to slide will be opposed. In Cervical traction the front end of the bed needs raising, and with Dunlop traction the side of the bed near the injury needs elevation.

Multiple Pulley Systems

In many situations multiple pulleys are used, so that less weights are necessary. Multiple pulleys are commonly used in pelvic traction where high forces (commonly up to 40 kg) may be needed.

Multiple pulleys decrease the force needed at the end rope

If a triple and double block were used as in the picture only 40/5 or 8 kg. would be required to generate the 40 kg. lift needed.