Understanding Buck's Traction
Traction Care
Ellie Grant
Grant, Ellie
Age 84 · #28451793 · Intratrochanteric hip fracture
The weight is applied and Ellie's Buck's traction is set up. Work through each tab to make sure you understand why she's in traction and how to keep her safe while she's in it.

Why Traction?

What is the main purpose of Ellie's Buck's traction?
Buck's traction is a temporary, skin-level traction. It doesn't heal the fracture on its own. Its job is to reduce muscle spasm around the fracture site, which eases pain and helps keep the leg in better alignment until surgical repair.

Safety Check

Mark each part of the setup as Safe or Unsafe.
Weights hang freely, without touching the floor or bed frame.
Correct: weights must hang freely at all times. If they touch the floor or bed, the pull is lost.
The rope sits securely within the pulley track.
Correct: the rope needs to move freely within the track to maintain a steady pull.
A knot in the rope is resting against the pulley.
Unsafe: a knot caught at the pulley can interrupt the pull and needs to be corrected.
Ellie's body is aligned straight with the direction of pull.
Correct: body alignment with the line of pull is what makes the traction effective.
The weights are lifted off and set back down each time Ellie is repositioned.
Unsafe: weights are never lifted or removed without an order. Reposition Ellie while keeping the pull intact, not by releasing the weights.

Extra Monitoring

Focused Assessment Affected Leg · q2h
Every 2 hours, you complete a focused assessment of Ellie's affected leg. Select all findings that would require immediate investigation.
Warm, pink toes with brisk capillary refill is a normal, reassuring finding.
Worsening pain unrelieved by medication can signal compartment syndrome or impaired circulation.
Mild bruising at a pin site is expected and doesn't need immediate escalation on its own.
Pallor is one of the classic signs of impaired circulation (the 5 P's).
A diminished or absent pulse needs immediate reassessment.
Numbness or tingling (paresthesia) is an early neurovascular warning sign.
Inability to move the toes (paralysis) is a late and serious sign.

Everyday Care

The CNA asks about helping Ellie to the bathroom. How should you respond?
CNA"Ellie says she needs to use the bathroom. Want me to help her onto the bedside commode?"
A bedpan lets Ellie use the bathroom without disrupting her traction. Getting her up to a commode would disturb the setup, and the answer isn't to shut the CNA out entirely. It's about directing the CNA to help safely with the bedpan, not doing it yourself or refusing the help.
The CNA asks you how to bathe Ellie. How should you respond?
CNA"Hey, can I go ahead and get Ellie cleaned up? What's the best way to bathe her with all this traction stuff set up?"
A bed bath keeps Ellie clean and comfortable without touching the traction setup. Telling the CNA to detach weights for a shower isn't safe, and skipping care of the leg isn't necessary or appropriate.
Nice Work
Why this matters: Traction only works if it stays intact. Every safety check and monitoring step you just walked through exists to protect the pull that's keeping Ellie's fracture aligned and her pain under control.
Take Card #44
Card 44 back
(image coming soon)