Chapter 16 Tibial Skeletal Traction
Precautions
3. Ensure that the pin is placed under sterile technique. Do not place pins through or near open wounds.
4. Ensure that the pin is placed perpendicularly to the axis of the limb and in a straight horizontal plane.
5. The Kirschner traction bow must be used with the Kirschner wire because it adds tension to the wire and prevents the wire from bending. Figure 16-1 illustrates the incorrect use of a Böhler’s stirrup, resulting in a wire without tension and significantly increasing the risk of wire breakage.
8. Apply rubber stoppers to the ends of the pin to prevent injury to the patient or health care workers.
Pearls
2. Insertion of tibial traction can be completed under local anesthetic, but conscious sedation is preferred.
4. If the patient is going to go to the operating room for definitive fixation shortly after placement of tibial traction, elective intubation prior to placement may be prudent.
5. Prior to placement of tibial traction, ensure that the patient is on a bed that is capable of having a traction frame attached to it.
6. Placement of a tibial pin is easiest when all the equipment is organized. Having two bedside tables facilitates organization and maintenance of a sterile environment.
