Traction Pins
Indications, landmarks, and safe technique.
Aug 15, 2026 · 3 refs
At a glance
Skeletal traction buys length, alignment, and comfort when a fracture will not wait quietly for definitive fixation. Done poorly, it creates infection, nerve injury, or a pin that does nothing useful.
Know the indication, the safe corridor, and what you will check after the weight goes on.
Decision-making
Use traction when soft tissue, OR timing, or polytrauma staging prevent early definitive fixation — classic examples include femoral shaft and some acetabular / unstable pelvic patterns awaiting the right window.
Ask: will traction improve length/alignment enough to matter, and is the soft tissue safe for a pin? Skin traction is not a substitute when skeletal control is required.
Technique pointers
- Confirm laterality, indication, and weight plan before prep
- Distal femoral and proximal tibial pins: know the safe zones relative to the physis (peds) and neurovascular structures
- Insert with sterile technique; protect soft tissue from thermal injury
- Apply bow / weight; re-check length, rotation, NV status, and skin
- Daily pin care and watch for loosening or infection
High-yield / exam
- Safe corridors matter more than speed
- Traction is temporary — have a definitive plan
- Recheck NV exam after weight application
- Pin-site infection is preventable with technique and care
Questions
On call and Boards items for this topic are coming.
Open the bank →Your pearl
One line you’d tell a junior at 2am.
References
- 01
Closed intramedullary nailing of femoral fractures — traction and reduction context
Winquist RA, Hansen ST, Clawson DK · 1984 · Journal of Bone and Joint Surgery (American) · review
Historical and practical context for length control before femoral nailing.
- 02
OTA resident teaching on skeletal traction indications and pin placement
2019 · Orthopaedic Trauma Association · guideline
Safe corridors and temporary role of traction in staged trauma care.
- 03
Skeletal traction in modern orthopedic trauma
2015 · Journal of the American Academy of Orthopaedic Surgeons · review
Summarizes when traction still earns its place despite early definitive fixation trends.
Related