Bucks traction-Contraindicated?

Specialties Med-Surg

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I am a new Rn on the surgical floor at a large hospital, more than an hour outside of the big city. I recently admitted a hip fracture. She was my first pre-op hip. Naturally, she was in incredible pain. She was admitted on a Friday night and the surgeon needed cardiac clearance before he would operate, therefore the surgery would not happen until after the weekend. The senior nurse said "we used to use bucks traction all the time, but not any more". I asked why, but no one on that shift knows. Anyone else have some information about it? Are other hospitals moving away from bucks traction?

I have not read any official research on this topic, but, one of our orthopedic surgeons will often D/C buck's traction placed by a fellow doc or just never order buck's traction to begin with because they believe that it often makes the patient more uncomfortable then they were prior to it. They also don't believe that it really does much of anything. In my personal experience the relief of pain, or lack of, varies from patient to patient with buck's traction. Some find it helpful while others want it off as quickly as it was placed. Would be interesting to hear about or see some newer research on it.

Specializes in PACU, pre/postoperative, ortho.

We don't routinely use it. Occasionally we'll see a prn order for Buck's & may try it for a pt who doesn't seem to get much relief from meds alone or is having a lot of spasms.

So I researched this topic a little more but did not come up with much. In my Med-Surg textbook it says "fracture alignment depends on the correct positioning and alignment of the patient while the traction forces remain constant. For extremity traction to be effective, forces must be pulling in the opposite direction. Countertraction is commonly supplied by the patients body weight or by weights pulling in the opposite direction, and may be augmented by elevating the end of the bed. It is imperative to maintain traction continuously and keep the weights off the floor and moving freely through the pulleys."

And

"Initially the affected extremity may be temporarily immobilized by Buck's traction until the patients physical condition is stabilized and surgery can be performed. Buck's traction relieves painful muscle spasms and is used for up to a maximum of 24 to 48 hours."

So, if I go from that information, I can say that my patient would have been in Buck's traction for close to 48 hours if surgery would have been performed on Monday. Close to the limit. Additionally, my patient had dementia and potentially would have been difficult to keep in one position in order for bucks traction to have been effective.

Is my thinking correct on this subject? What do ya'll think?

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