Medical traction is a treatment method where a pulling force is applied to an injured part of the body to stabilize it, restore alignment, and relieve pain. This technique employs a system of weights, ropes, and pulleys to exert a steady, continuous pull on the affected limb. Buck’s traction, also known as Buck’s extension, is one of the most common forms of this treatment still used today. It is a type of skin traction, meaning the force is applied indirectly through the skin and soft tissues, and it is primarily used as a temporary measure for injuries involving the lower extremities.
The Principle of Skin Traction
Buck’s traction works by creating a low-force, longitudinal pull along the axis of the injured limb. This is achieved through the application of a specialized adhesive tape or a prefabricated foam boot applied directly to the skin of the leg. This material is then connected to a rope that runs through a pulley system mounted to the foot of the patient’s bed.
A weight is attached to the rope’s end, providing the constant, gentle force that pulls the limb away from the torso. The patient’s own body weight serves as the counter-traction, providing the necessary opposing force. The primary goal of this constant pull is to reduce painful muscle spasms, which often occur immediately after a fracture or severe injury.
This method is distinguished from skeletal traction, which is more invasive and involves surgically inserting pins or wires directly into the bone. Because Buck’s traction transmits the pull through the skin, the maximum weight applied is relatively light, typically between five and ten pounds (2.3 to 4.5 kilograms), to prevent skin damage.
Common Medical Uses
Buck’s traction is most often implemented as a provisional treatment for trauma to the hip and femur. One of its most frequent applications is the temporary immobilization of a hip fracture in elderly patients while they await surgical repair. By stabilizing the fracture site, the traction helps to significantly reduce the severe pain associated with the injury.
It is also used to stabilize certain fractures of the femur (thigh bone) or injuries around the knee joint before definitive treatment can be carried out. The continuous alignment force helps prevent the powerful surrounding muscles from shortening the limb and causing further displacement of bone fragments. This traction is generally a short-term intervention, often used for only 24 to 72 hours, until the patient is stable enough for surgery or another long-term solution.
Practical Patient Considerations
Patients undergoing Buck’s traction must maintain strict immobility, which requires them to remain flat in bed for the entire duration of the treatment. The foot of the bed is often slightly elevated to enhance the counter-traction provided by the patient’s body weight, ensuring the force is effective. A strict regimen of monitoring and care is necessary to prevent complications due to confinement.
Caregivers must frequently assess the skin integrity underneath the applied tape or foam boot and at pressure points on the rest of the body. Areas like the heels, ankles, and sacrum are particularly susceptible to pressure sores due to the continuous contact with the bed surface. Regular neurovascular checks are also performed to monitor the limb’s circulation, sensation, and movement.
Managing basic hygiene, nutrition, and elimination requires assistance from the medical team while the patient is fully confined. Though the treatment duration is short, the risk of complications such as deep vein thrombosis (DVT) from prolonged bed rest must be actively managed through preventative measures. The entire care plan focuses on patient comfort, preventing secondary injury, and maintaining the system’s integrity until the underlying injury can be surgically addressed.