Skeletal traction for the management of lower limb fractures: Its relevance today

Abstract

Purpose: Skeletal traction is one of the modalities of treatment for fractures involving appendicular skeleton. The purpose of our study is to evaluate the clinical and radiological outcomes of skeletal traction applied to injuries involving lower limb as a temporary / definitive procedure.Methods: We have included 108 patients with various injuries involving bones of lower limb. Modalities of traction included upper/lower tibial pin traction/calcaneal pin traction. Steinmann pins (4.5mm to 5.5mm) Bohler stirrup and Bohler Braun splint were used for applying traction. X-rays were taken before and after skeletal traction and also every time when the weight of traction was either increased or decreased. The end point for removal of the traction apparatus was either surgery or POP application or fracture union. Until then quadriceps and ankle mobilisation exercises were performed. Results: Results were analysed based on skin healing, bone healing, joint scores (Harris hip score, WOMAC score, Peterson score). Complications usually encountered were pin tract Infections. Most of the cases showed good results in either assisting the surgeon for closed manipulation and implantation during surgery, or for successful healing in good alignment in patients who were not fit for surgery or not willing for surgery.Conclusion: Skeletal traction, even though rarely used nowadays, is still an important modality of treatment in selected situations where surgery may be delayed, denied or contraindicated for various reasons.