Skin Traction: Principles, Application, and Clinical Use

What Is Skin Traction?

Skin traction (adhesive traction) applies a pulling force to a limb via adhesive straps or tape attached to the skin, transmitting force through soft tissues to the bone. It is a temporary, non-invasive method for fracture stabilization, muscle spasm relief, or preoperative alignment.

Common Types

Type	Application	Typical Weight	Indications
Buck's traction	Adhesive foam strap on leg + spreader + weight over pulley at foot of bed	4.5–9 kg (10–20 lb)	Hip/femur fractures, hip dislocation, preoperative
Russell's traction	Buck's + sling under knee (flexes hip/knee)	Similar	Femoral shaft fractures (allows knee flexion)
Dunlop's traction	Upper limb: adhesive on forearm + overhead pulley	1.5–3 kg	Humerus/forearm fractures, shoulder dislocation
Cervical traction (skin)	Halter under chin/occiput + weight over pulley	3–5 kg	Cervical spondylosis, radiculopathy (short-term)

Key Principles

• Countertraction: Patient's body weight + friction + bed elevation (foot of bed raised) provides opposing force.
• Alignment: Force vector must align with bone axis.
• Skin integrity: Assess frequently; remove if breakdown, neuropathy, allergy. Max 2–3 weeks.
• Neurovascular monitoring: q1–2h initially (pulses, sensation, movement, color, temperature).

Limitations vs. Skeletal Traction

• Lower weight tolerance (skin shear limit ~5–10 kg).
• Less precise control; soft tissue creep.
• Skin complications: blisters, necrosis, nerve compression (peroneal at fibular head).
• Not definitive for unstable fractures.

Contraindications

• Skin breakdown, burns, dermatitis at application site
• Peripheral vascular disease, neuropathy
• Fractures requiring precise reduction/long-term immobilization
• Compartment syndrome risk

Skin traction is a bridge to definitive treatment (surgery, skeletal traction, casting) or for short-term symptomatic relief.