When to apply Buck's traction (skin traction)?

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DS

Dainyal Siddiqui, MD

Internal Medicine

MJ

Manuel Jimenez, MD

Cardiology

FP

Franz Pierre-Louis, MD

Infectious Disease

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Last updated: May 26, 2025 • View editorial policy

From the Research

Buck's traction should be applied immediately after diagnosis for patients with hip fractures, femur fractures, or hip dislocations as a temporary measure before definitive surgical treatment, typically within 24-72 hours, as it helps reduce pain, prevent muscle spasms, and maintain limb alignment 1. The decision to use Buck's traction is based on the need for temporary stabilization and alignment of the affected limb, and it is particularly useful for elderly patients with hip fractures awaiting surgery, children with femur fractures, and patients with hip dislocations requiring temporary stabilization. Some key points to consider when applying Buck's traction include:

  • The traction involves applying 5-7 pounds of weight to the affected limb using adhesive tapes, foam boots, or skin sleeves attached to a pulley system.
  • Buck's traction helps reduce pain, prevent muscle spasms, maintain limb alignment, and minimize further soft tissue damage by counteracting muscle forces that cause shortening and displacement of bone fragments.
  • It is essential to convert Buck's traction to surgical fixation as soon as the patient's condition allows, as prolonged traction can lead to complications like pressure sores, deep vein thrombosis, and muscle atrophy. A study published in the Journal of Orthopaedic Trauma in 2012 found that preoperative cutaneous traction versus skeletal traction in adults with diaphyseal femur fractures amenable to fixation within 24 hours resulted in a significant reduction in time of application for the cutaneous traction group 1. Another study published in the Journal of Trauma in 2010 compared the major physiologic clinical outcomes of provisional skeletal traction with damage control external fixation of femoral shaft fractures in severely injured patients and found that skeletal traction offered no significant advantage in clinical outcomes compared with external fixation 2. However, the most recent and highest quality study on the topic, published in 2016, reviewed lower extremity traction in current orthopaedic trauma and highlighted the importance of proper traction techniques and patient evaluation methods to accomplish the task of reducing pain and preventing muscle spasms 3.

References

3
Research

Review of Lower Extremity Traction in Current Orthopaedic Trauma.

The Journal of the American Academy of Orthopaedic Surgeons, 2016

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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