# Manual traction for joints



## Ediron (Dec 20, 2009)

I was reading my book 
and it says "Generally, you should not try to align a wrist, elbow, knee, hip, or shoulder"

that still doesnt make it clear for me
can someone clarify this 
thanx


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## EMSLaw (Dec 20, 2009)

Ediron said:


> I was reading my book
> and it says "Generally, you should not try to align a wrist, elbow, knee, hip, or shoulder"
> 
> that still doesnt make it clear for me
> ...



I'm not sure what your question is.  Generally, EMT-Basics do not reduce fractures in the field.  You splint the injury as you find it, using splints, padding and cravats to secure it in the position most comfortable to the patient. 

The exception is a closed mid-shaft femur fracture, which calls for the use of a traction splint.  Using a traction splint, you are effectively realigning the femur to reduce pain and prevent further internal damage.  You might also apply some manual traction to the long bones of the arm, though there is a difference in protocol on that.


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## DV_EMT (Dec 20, 2009)

generaly... as an EMT.. you are allowed to pull traction for femor fractures as it can be potentially life threatening. 

Aside from that... the only other time you'd want to move an injury is if it caused no pulse to the extremity.

so you book is more or less on par.


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## medicdan (Dec 20, 2009)

Another instance where an EMT would consider pulling traction to realign a bone or joint is when there would be an extreme delay to the delivery to definitive care, and even in that case, practitioners are trained in the safe performance of the skill (Willderness EMS comes to mind). 
Can someone tell me why we realign a displaced mid-shaft femur fracture if found, before transporting?


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## EMSLaw (Dec 20, 2009)

emt.dan said:


> Another instance where an EMT would consider pulling traction to realign a bone or joint is when there would be an extreme delay to the delivery to definitive care, and even in that case, practitioners are trained in the safe performance of the skill (Willderness EMS comes to mind).
> Can someone tell me why we realign a displaced mid-shaft femur fracture if found, before transporting?



One is the damage to the muscle done by the displacement of the bone, because the femur and the surrounding muscles are among the strongest in the body.  Another is the danger of damage to the femoral artery.  Also, traction gives pain relief, and a femur fracture is fantastically painful.


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## Jeffrey_169 (Jan 9, 2010)

I believe your book is telling to splint as you find it; on a femur you can pull traction, but for most others you splint as you find it. Some protocols state to splint in the position of function, but this is only if it can be accomplished without causing further pain or injury.


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