Page 171 - ASOP ROT Study Guide

Balanced traction
Balanced traction is used where static traction is in danger of causing damage to a part of the body
through pressure. Here the pull against the ring (and thus the pelvis) is balanced by a weight
attached to the whole splint. This takes the pressure off the skin round the ring while maintaining
traction on the leg (Figure below).

http://www0.sun.ac.za/ortho/webct-
ortho/general/trac/ThomasTraction-child.png
FIGURE A PULL IS MOUNTED ACROSS THE FRACTURE OF THE FEMUR USING THE
THOMAS SPLINT.

Dynamic traction
Dynamic traction is used where joints are still permitted to move but, by means of pulleys, the pull
is still maintained along the line of the broken bone. In this case weights provide the pull and the
counter force is achieved by tilting the bed.
Traction may be applied using strapping stuck onto the skin. The weights used are not large
and are applied only for short periods of time (a few days). This is particularly useful when traction
is being used to relieve pain, such as following a fracture of the femoral neck. This technique
results in a change in muscle tone, relieving muscle spasm and diminishing the need for pain-killing
drugs.
For long term traction, requiring larger weights, a pin inserted through the bone is preferable and
in the long run easier to manage. Pins can be problematical if they loosen, and/or if they become
infected. Regular nursing care of pin tracts is essential to keep them clean and dry.
Traction, apart from being a short term pain relieving measure, is useful where other external
treatment methods are problematic. It is frequently used for treatment of fractures of the femur
where splintage to include the hip joint, although not difficult, is rather impractical, especially in the
adult. It is also useful as an alternative to external fixation when there is a large degree of soft tissue
damage. The main problem with traction is that the injured person must remain in bed, making
hospital stay prolonged and nursing care difficult.