In the upper limb, traction may be applied by gravity - using a wrist sling, plaster of paris or a removable plastic sleeve, the weight of the arm provides traction to the humerus.
In skin traction, weights are attached by cords to adhesive strapping on the skin. The traction is applied to the fracture indirectly via the soft tissue, up to a limit of about 5 kg.
In skeletal traction, traction is applied to pins or wires passed through the bone. The technique is most often used in the lower limb in which insertion is normally behind the tibial tubercle for hip, thigh or knee injuries, or through the calcaneum for tibial fractures, but may also be applied to the skull, pelvis and other sites. The technique is more comfortable than skin traction and permits much greater forces to be applied.
In fixed traction, pull is exerted against a fixed point. This may be with a splint such as the Thomas splint or with gravity, for example, the Gallows traction for young children with fractured femurs.
In balanced traction, pull is exerted against an opposing force provided by the weight of the body when the foot of the bed is raised. The patient is more comfortable since the broken limb doesn't rub against the bed, and nursing is made easier since it is relatively easy to move the patient.
Combined traction is similar to fixed traction except that the split is suspended or tied to the end of a raised bed.
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