Skeletal traction is a treatment method for broken bones. It’s a system where a combination of pulleys, pins, and weights is used to boost the healing of fractured bones. These are usually to treat bone fractures in the lower body.
In skeletal traction, a pin is placed inside your bone. That pin provides a base for a pulley system. It uses a gradual pulling force to realign broken bones and promote proper healing.
There are two common types of traction. These include skin traction and skeletal traction. The difference lies in where the pin, or base, is placed. Skeletal traction uses a pin inserted into your bone. In skin traction, a splint or adhesive is applied to your skin.
When Is Skeletal Traction Used?
Skeletal traction is a treatment method for broken bones that dates back to the 13th century. It’s mainly used for treating broken bones in the lower body.
These days, it’s mainly used in acute trauma settings as a temporary treatment before surgery. Using skeletal traction can help stabilize and realign your bones until you can have a permanent surgical fix.
“Injuries requiring skeletal traction are generally emergencies that no patient was expecting,” says Jennifer Tucker, MD, double board-certified orthopedic surgeon at HCA East Florida Division in Fort Lauderdale, Florida.
She says that skeletal traction is often a stopgap measure designed to buy time when immediate surgery isn’t possible. “The majority of these patients have suffered severe trauma and likely have multiple organ systems affected, which need to be stabilized medically prior to having their fractures definitively treated in the operating room,” Tucker says.
What Conditions Are Treated With Skeletal Traction?
Skeletal traction is commonly used for fractures in the following bones:
- Upper leg bone (femur)
- Lower leg bone (tibia)
- Upper arm bone (humerus)
- Hips
- Pelvis
- Lower spinal area (cervical spine)
In addition to fractures of the hip, femur, and tibia, skeletal traction may be used to treat breaks in the cervical spine (neck) or finger pilon, the bone just below your knuckle.
What to Expect During Skeletal Traction Treatment
During skeletal traction, an orthopedic surgeon will insert a pin in a certain part of your bone, depending on which bone you’ve broken and how it needs to be fixed. Local anesthesia is applied before this happens.
A weight of up to 15 pounds is attached to one end of the pulley in the traction mechanism. This provides a force to adjust the bones after a fracture. It also helps them return to their proper position.
A system of pulleys will realign the broken bone properly, preparing you for a successful surgery.
While you’re in the hospital, your nurse will check the traction site. They’ll check the skin around the pins for any signs of infection, such as blisters, redness, heat, and swelling. Your doctor will regularly take and review images of your injury to see how you’re healing. They’ll adjust your traction if needed.
Is skeletal traction painful?
The idea of skeletal traction might sound painful, but the actual procedure shouldn’t be. Your surgeon will give you local or general anesthesia before they insert the traction pins. Once traction is applied and your bones are realigned, you’ll feel less pain.
How is skeletal traction removed?
After your doctor performs surgery to fix your broken bone, they’ll remove the pins. Your doctor will give you a local anesthetic so you don’t feel pain. They’ll thoroughly clean the pin site and may make small cuts in your skin near the pins to make them easier to remove. They’ll use special tools to unscrew the pins, then they’ll clean the site again and cover it with a clean gauze or other dressing to protect the wound and help it heal.
How Long Is Skeletal Traction Used?
That depends on which bone is fractured and how severe your injury is. Long-term skeletal traction comes with risks, so your surgeon will use this method just long enough to stabilize your injury until you can have more permanent surgery.
What’s the Difference Between Skin Traction and Skeletal Traction?
In skeletal traction, a surgeon inserts a pin directly into your bone, and pulleys and weights are used to gradually realign your bones so they can heal properly.
Skin traction is used when soft tissues, such as your muscles and tendons, need to be repaired. For this, your doctor attaches tape, a bandage, or other material to your skin and uses a weight to create a pulling action. Over time, this moves your fractured bones and soft tissue around them back into place.
What Are the Benefits of Skeletal Traction?
Breaking a bone can be a very painful experience. It can also disrupt your daily life. It’s important to take all the necessary steps to make sure your broken bone heals properly. Otherwise, you could be dealing with the same problem for quite some time.
Skeletal traction is designed to put your bones back in place after a traumatic fracture. Accidents can make your bones break into small pieces. This makes it hard to regain the full use of them without the proper treatment.
The muscle around your broken bone can contract. This makes the bones shorten as they heal and is common when a child breaks their leg. It can result in one leg growing longer than the other.
Skeletal traction can be used as a temporary measure. The main benefits of skeletal traction are:
- Joint or bone immobilization
- Reducing or realigning dislocations and fractures
- Preventing and reducing muscle spasm
- Relieving pressure and pain
- Easing pressure on spinal nerves
- Promoting patient comfort until a treatment option is decided
What Are the Risks of Skeletal Traction?
There are lots of benefits of skeletal traction. But as with most medical treatments, there can be complications, too.
These problems usually happen because the limb doesn’t move much and stays in one position for a long time. Some of the complications include:
Infection. In skeletal traction, a metal pin is inserted into your bone. This pin acts as a base for reducing the fracture. The insertion site can become infected, whether it is in bone or soft tissue.
Pressure sores. Also known as pressure ulcers or bedsores, they can happen when you’re lying in the same position for an extended period of time. They often form in areas where your bones are close to your skin.
Nerve damage. There are different ways your nerves can be damaged when undergoing skeletal traction. Pin insertion and wire arrangement are factors, but more research is needed to fully understand the risks.
Misalignment of the bone or joint. Medical staff will make every effort to realign your joints or broken bones correctly. But misalignment can happen in some cases.
Stiff joints. Your joints can become stiff from traction. This is possibly due to reduced blood flow.
Wire malfunction. The wires that suspend your limb during skeletal traction can sometimes malfunction or break.
Deep vein thrombosis (DVT). DVT is when you develop a large blood clot in your deep veins. It usually happens in your legs when you’re unable to move for a long period.
Takeaways
Skeletal traction uses pulleys, pins, and weights to realign and stabilize a fracture or keep your joints aligned as your bone tries to heal. It’s used in cases of acute trauma, where immediate surgery might not be possible. The goal is to keep the injury stable until surgery can be performed. Once commonly used, skeletal traction is less common now, thanks to medical and surgical advancements.
Skeletal Traction FAQs
How effective is skeletal traction for fractures?
Skeletal traction is an effective, temporary measure to help stabilize and realign a fracture until you can have surgery. But it does have possible side effects, such as infection, joint stiffness, muscle wasting, and blood clots caused by being immobile for a long period. So, surgeons often opt for newer, more advanced procedures that allow for earlier mobilization and shorter hospital stays.
Can you walk while in skeletal traction?
No. The goal of this procedure is to stabilize your broken bones until you’re able to have surgery to permanently fix the problem.
What are the side effects of long-term skeletal traction?
There are a number of risks that come with long-term skeletal traction. These include:
- Loosening, bending, or breaking of traction pins
- Wound healing problems
- Infection
- Muscle wasting
- Joint stiffness
- Deep vein thrombosis (DVT)
- Prolonged immobilization
How is skeletal traction maintained in hospitals?
While you’re in the hospital, your nurse will check the traction site. They’ll check the skin around the pins and look for signs of infection, such as blisters, redness, heat, and swelling. Your doctor will regularly take and review images of your injury to see how you’re healing. They’ll adjust your traction if needed.
What’s the recovery process after skeletal traction?
This depends on several things, such as which bone or joint was injured, how severe your injury is, and any other medical conditions you may have. You’ll stay in the hospital while you’re in skeletal traction, which can be as long as six weeks or more. After you have surgery to repair your fracture, your doctor will remove the pins. Your orthopedist will decide when you can resume regular activities based on follow-up exams and imaging, such as X-rays.
If you have multiple injuries, you’ll likely stay in the hospital until they’ve all been treated and healed or stabilized enough for you to go home.
