Mechanical traction exerts a pulling force on a part of the body— usually the spine, pelvis, or long bones of the arms and legs. It can be used to reduce fractures, treat dislocations, correct or prevent deformities, improve or correct contractures, or decrease muscle spasms. Depending on the injury or condition, an orthopedist may order either skin or skeletal traction.

Applied directly to the skin and thus indirectly to the bone, skin traction is ordered when a light, temporary, or noncontinuous pulling force is required. Contraindications for skin traction include a severe injury with open wounds, an allergy to tape or other skin traction equipment, circulatory disturbances, dermatitis, and varicose veins.

With skeletal traction, an orthopedist inserts a pin or wire through the bone and attaches the traction equipment to the pin or wire to exert a direct, constant, longitudinal pulling force. Indications for skeletal traction include fractures of the tibia, femur, and humerus. Infections such as osteomyelitis contraindicate skeletal traction.

The design of the patient’s bed usually dictates the type of traction frame used.

Setup of the specific traction can be done by a nurse with special skills, an orthopedic technician, or the doctor. Instructions for setting up these traction units usually accompany the equipment.

After the patient is placed in the specific type of traction ordered by the orthopedist, the nurse is responsible for assessing and managing the patient’s pain; preventing complications from immobility; routinely inspecting the equipment; adding traction weights, as ordered; and, in patients with skeletal traction, monitoring the pin insertion sites for signs of infection.