Buck’s traction is a non-surgical orthopedic method utilizing mechanical tension to provide temporary treatment for certain injuries, particularly those involving the lower extremities. This technique applies a steady, pulling force, known as traction, to a damaged limb. Its primary function is to stabilize a fracture or joint injury and relieve intense pain by relaxing surrounding muscles, serving as an initial step in managing orthopedic trauma. It is typically used for short periods to prepare a patient for definitive treatment, such as surgery, or while acute swelling subsides.
Defining Buck’s Traction and Its Mechanism
Buck’s traction is classified specifically as a form of skin traction, which distinguishes it from the more invasive skeletal traction. The apparatus is designed to apply a longitudinal pull along the limb by indirectly engaging the bone through the soft tissues. This system uses a combination of adhesive straps, a specialized foam boot, or skin sleeves that are wrapped around the leg, most commonly from the ankle to the knee.
The physical setup requires ropes, a single pulley, and specific weights attached to the extremity and hung over the end of the bed. This arrangement applies a continuous, gentle force that pulls the limb, counteracting the powerful muscle spasms that occur after a fracture. The weight used is relatively light, often ranging between five and seven pounds (up to 4.5 kilograms), because the force is transmitted only through the skin and soft tissue layer. This lighter weight limits the risk of skin damage, unlike skeletal traction where pins are inserted directly into the bone to apply heavier forces.
Primary Medical Conditions Treated
The main clinical indication for using Buck’s traction is to provide immediate, temporary stabilization and pain relief for specific lower extremity fractures. It is frequently employed in the emergency management of hip fractures or fractures of the femur, which is the long bone in the thigh. By applying tension, the traction helps to maintain the length of the fractured bone and prevent further displacement of the broken fragments before surgery can be performed.
A primary goal of the procedure is to lessen the severe muscle spasms that cause significant pain and can worsen the injury. These spasms are the body’s involuntary attempt to splint the broken bone, resulting in painful shortening and misalignment of the limb. Buck’s traction gently fatigues these muscles, reducing pain and improving the alignment of the bone fragments. This temporary use acts as a bridge, keeping the patient comfortable and the limb stable while the medical team prepares for definitive internal fixation.
Patient Care and Monitoring During Traction
The successful application of Buck’s traction depends on meticulous patient care and constant monitoring to prevent complications from immobility and the device itself. Maintaining proper body alignment is paramount, requiring the patient to remain supine and centered in the bed. This ensures the counter-traction—the weight of the patient’s body—is effective. The weights must always hang freely and should never rest on the floor or the bed frame, as this negates the intended pulling force.
A critical aspect of care involves frequent neurovascular assessments of the affected limb, typically performed every four hours. Healthcare providers check the five P’s to ensure adequate circulation and nerve function below the traction site.
- Pain
- Pallor (color)
- Pulse
- Paresthesia (sensation)
- Paralysis (movement)
Any change in the limb’s color, temperature, or the patient’s ability to move their toes or feel light touch must be reported immediately, as these are signs of potential nerve or vascular compromise.
Skin integrity checks are performed multiple times a day, focusing on the area under the traction boot or straps and over bony prominences like the heel. Since the force is applied to the skin, friction and pressure can quickly lead to skin breakdown and pressure ulcers. The patient’s immobility increases the risk of developing pressure injuries and deep vein thrombosis (blood clots). Nursing care includes encouraging deep breathing exercises, repositioning the patient within the constraints of the traction, and administering prescribed anticoagulants to mitigate these risks.