Traction is a medical technique used to stabilize or realign an injured body part, such as a fractured bone or dislocated joint. This intervention involves applying a pulling force to the affected area to maintain alignment and reduce muscle spasms. Skin traction is a non-invasive method that achieves this therapeutic pull by applying force indirectly. It is often the initial step in managing certain orthopedic injuries due to its immediate effect on pain relief and stabilization.
Defining Skin Traction
Skin traction transmits a gentle pulling force to the bone through the body’s soft tissues, including the skin, fascia, and muscles. The procedure involves securing a material, such as an adhesive strap or a foam boot, directly onto the skin of the injured limb. A rope is then attached to this material and threaded through a pulley system connected to the bed frame.
A specific amount of weight is attached to the rope to create the continuous pulling force. Because the force is applied only to the skin, the weight must be kept low to prevent irritation, blistering, or slippage. For most adults, the weight is restricted to a maximum of about 5 to 10 pounds (2.3 to 4.5 kilograms). This controlled, low-level force is designed to overcome muscle tension and temporarily stabilize the injury.
Common Medical Applications
The primary goal of using skin traction is to provide temporary stabilization and pain relief for specific injuries. One frequent application, often known as Buck’s traction, is the initial management of hip and femur fractures before surgery. Applying a steady, light pull helps align the bone fragments and maintain the limb’s proper length.
This gentle force is particularly effective at relieving painful muscle spasms that frequently accompany fractures. When a long bone breaks, the surrounding powerful muscles contract intensely, increasing pain and worsening the displacement of the bone ends. Skin traction counteracts this spasm, offering immediate comfort and preventing further soft tissue damage.
The Traction Application Process
The application of skin traction requires careful preparation and specific equipment to ensure the force is applied correctly and safely. The process begins with securing adhesive straps or a foam boot to the limb, ensuring the material is free of wrinkles that could cause pressure points. A spreader bar is then attached to the end of the strapping to prevent pressure on the ankle or foot.
The rope is connected to the spreader bar and passed over a pulley mounted on a frame at the foot of the bed. The prescribed weight is then attached to the rope, ensuring it hangs freely without touching the floor or the bed. The bed is often elevated at the foot end, allowing the patient’s body weight to act as a counter-traction force.
Continuous monitoring is required, including regular checks of the skin for any signs of breakdown or blistering. A neurovascular assessment is a critical component of ongoing care, checking the circulation, sensation, and movement of the affected limb. The healthcare team must check for signs of impaired blood flow, such as a weak pulse or cool skin, and nerve compression, like numbness or tingling. Skin traction is typically a short-term measure, often maintained for only 24 to 48 hours, until the patient is ready for a more definitive treatment.
Skin Traction Versus Skeletal Traction
While both skin traction and skeletal traction apply a pulling force to an injured limb, they differ significantly in method and intensity. The fundamental difference lies in the invasiveness of the procedure and the magnitude of the force applied. Skin traction is non-invasive, as the apparatus adheres only to the skin and soft tissue.
In contrast, skeletal traction is an invasive surgical procedure where a metal pin, wire, or screw is inserted directly into the bone. This direct connection allows skeletal traction to bypass the soft tissues and apply a much greater pulling force, often using weights far exceeding the 10-pound limit of skin traction. Consequently, skeletal traction is used for more complex fractures or when high-force realignment is required.