Traction
Formal Definition
The application of a longitudinal pulling force to a fractured bone or dislocated joint to achieve or maintain anatomical alignment; types include skin traction (force applied via straps on the skin surface) and skeletal traction (force applied via a pin or wire through the bone), used preoperatively, as definitive management in select cases, or to relieve pain and muscle spasm.
How It's Used on the Ward
"Patient is in traction" or "put them in Buck's traction" — used in hip fractures awaiting surgery to reduce pain and prevent shortening/rotation.
Example
""Intertrochanteric hip fracture in a 78-year-old anticoagulated patient: in Buck's traction for comfort overnight, hematology consulted for reversal, OR scheduled for tomorrow once INR < 1.5.""
Clinical Context
Buck's traction is skin traction used pre-op for hip fractures — reduces spasm and pain while awaiting surgery. Skeletal traction (e.g., 90/90 traction for femur fractures in children, tibial pin traction) applies higher forces directly through bone. Complications: pressure ulcers (skin traction), pin site infection, neurovascular compromise, compartment syndrome. Mostly supplanted by early surgical fixation for definitive management.
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