An 8-year-old sustains an open compound femur fracture. What type of traction should the nurse expect to be used?


• 90–90 traction is a type of skeletal traction often used for femur or tibia fractures.

• The pin is placed through the proximal end of the tibia, allowing traction suspension of the extremity in 90 degrees of flexion at the hip and knee. This involves suspending the leg so the thigh is vertical (hip at 90 degrees) and the knee is bent (knee at 90 degrees) with the lower leg resting horizontally above the bed in the traction sling.

Incorrect options:

• Thomas splint traction is a skin traction. It involves bandages wrapped around the entire length of the leg. An attached ring applies traction at the heel. (In adults, the knee is left slightly bent.) Skin traction would not be the first choice with an open compound fracture because it dislocates tissue while in traction, and this patient has a wound that requires dressing changes.

• Buck's traction is another skin traction that applies simple horizontal traction. This is also not ideal with an open fracture due to dislocation and pull on the skin.

• Fisk traction is a skin traction—specifically, a modification of a Thomas splint that allows for 90-degree movement of the knee. Skin traction is contraindicated with open compound fractures.

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