Traction is the use of weights, ropes and pulleys to apply force to tissues surrounding a broken bone.
It's sometimes used to keep a broken leg in the correct position during the early stages of healing, or to ease the pain of a fracture while a person is waiting for surgery.
When traction is used
There are several situations when traction may be used. For example, it may be used to:
realign and fix bone fractures, such as a broken leg
help reduce pain before surgery
treat bone deformities caused by conditions such as scoliosis
correct a muscle contracture (shortening of a muscle)
Types of traction
The two main types of traction are skin traction and skeletal traction.
Skin traction is usually carried out while a person is lying in a hospital bed. It uses equipment such as splints, bandages and adhesive tape that are attached to weights.
A pulling force is applied through soft tissues, such as the skin, muscles and tendons. The affected area of the body is pulled in line using a pulley system attached to the bed.
Skeletal traction is used when a greater force needs to be applied. The force is applied directly to the skeleton, which means additional weight can be added without the risk of damaging the surrounding soft tissues.
The skin can usually support up to 3.5kg (8lb), whereas the skeleton can support up to 12kg (25lb).
During skeletal traction, pins, wires or screws are surgically inserted into the bone. This can be carried out using either a local anaesthetic or a general anaesthetic.
After the pins, wires or screws have been inserted, weights are attached to them so that the affected body part can be pulled into the correct position.
The length of time skeletal traction needs to be used for will depend o
n how badly injured the bones are.
Does traction work?
Traction is effective in providing temporary pain relief in the early stages of treatment after trauma. For long-term (chronic) conditions, there's little scientific evidence to support the use of traction.
Skin or skeletal traction was often routinely applied to the limb of a fractured hip before surgery. However, recent research has shown this appears to have little or no benefit.
There's also little evidence to show traction is an effective method of treating spinal conditions such as:
sciatica (pain caused by irritation or compression of the sciatic nerve)
Several studies have either produced inconclusive results or concluded that there are more effective methods of treating these conditions, such as exercise and physiotherapy.
Although skin and skeletal traction may be used to treat certain types of fracture, traction isn't usually needed for minor fractures.