OTC Orthopaedic Technologist Certified Traction Principles and Application 4 — Questions and Answers
Question 1: Which neurovascular check finding warrants IMMEDIATE notification of the supervising physician in a patient in traction?
- Mild edema distal to the traction
- Capillary refill of 2 seconds
- Absent distal pulse with paresthesia (Correct answer)
- Skin temperature equal bilaterally
Correct answer: Absent distal pulse with paresthesia
Absent distal pulse combined with paresthesia indicates vascular compromise or compartment syndrome and is a surgical emergency requiring immediate intervention.
Question 2: Pin site care for skeletal traction typically includes:
- Packing the site with petroleum gauze twice daily
- Cleaning with prescribed solution and monitoring for signs of infection (Correct answer)
- Leaving the site completely open to air with no dressing
- Applying antibiotic ointment and occlusive dressing only on day 1
Correct answer: Cleaning with prescribed solution and monitoring for signs of infection
Pin sites require routine cleaning with an approved solution (e.g., chlorhexidine or normal saline) and monitoring for erythema, drainage, or loosening.
Question 3: A patient in traction reports burning and itching under the foam boot. The FIRST action should be to:
- Increase the traction weight to distract attention from the discomfort
- Remove the boot, inspect the skin, and reapply if intact (Correct answer)
- Apply a topical steroid under the boot
- Notify the surgeon immediately without removing the boot
Correct answer: Remove the boot, inspect the skin, and reapply if intact
Burning and itching suggest skin irritation or early breakdown; the boot must be removed for skin inspection before any further intervention.
Question 4: Which complication is most unique to skeletal traction compared to skin traction?
- Pressure ulcers
- Osteomyelitis from pin tract infection (Correct answer)
- Deep vein thrombosis
- Muscle atrophy
Correct answer: Osteomyelitis from pin tract infection
Pin tract infection leading to osteomyelitis is a risk specific to skeletal traction because the pin breaches the skin and cortex, providing a pathway for bacteria.
Question 5: To monitor for foot drop in a patient in lower extremity traction, the technologist assesses:
- Grip strength of the ipsilateral hand
- Ability to dorsiflex the foot against resistance (Correct answer)
- Sensation over the medial thigh
- Patellar reflex on the affected side
Correct answer: Ability to dorsiflex the foot against resistance
Foot drop results from peroneal nerve injury; assessment of dorsiflexion strength is the primary functional test for this complication.
Question 6: When repositioning a patient in skeletal traction, which of the following is essential?
- Temporarily removing the traction weights during the move
- Maintaining the prescribed traction force throughout the repositioning (Correct answer)
- Flexing the knee to 45° to relieve pin site stress
- Disconnecting the pulley to allow a full range of movement
Correct answer: Maintaining the prescribed traction force throughout the repositioning
Traction force must be maintained continuously during repositioning to prevent fracture displacement and loss of reduction.
Question 7: What is the recommended frequency for neurovascular checks in a newly admitted traction patient?
- Every 8 hours
- Every 4 hours for the first 24 hours, then every 8 hours
- Every hour for the first 24 hours (Correct answer)
- Once per shift after the initial assessment
Correct answer: Every hour for the first 24 hours
Newly applied traction demands hourly neurovascular checks for the first 24 hours to detect early vascular compromise or compartment syndrome.
OTC Orthopaedic Technologist Certified Traction Principles and Application 4
Which neurovascular check finding warrants IMMEDIATE notification of the supervising physician in a patient in traction?