OTC Orthopaedic Technologist Certified Traction Principles and Application 5 — Questions and Answers
Question 1: Traction is generally contraindicated in which of the following scenarios?
- Intertrochanteric hip fracture awaiting surgery
- Femoral shaft fracture in a 5-year-old
- Open fracture with active vascular injury requiring repair (Correct answer)
- Cervical radiculopathy unresponsive to conservative care
Correct answer: Open fracture with active vascular injury requiring repair
An open fracture with active vascular injury requires emergent surgical repair; applying traction could worsen vascular compromise and delay definitive treatment.
Question 2: Which modification is recommended when applying skin traction to a geriatric patient with fragile skin?
- Doubling the foam boot padding to increase friction
- Using pre-padded or non-adhesive traction kits and reducing weight (Correct answer)
- Applying an adhesive elastic bandage directly to the skin
- Increasing traction weight to shorten the treatment duration
Correct answer: Using pre-padded or non-adhesive traction kits and reducing weight
Non-adhesive, pre-padded traction kits and reduced weights minimize shear and pressure forces on fragile geriatric skin, reducing the risk of skin tears.
Question 3: In children, which fracture pattern most often necessitates overhead (Bryant's or 90-90) traction rather than skin boot traction?
- Distal radius buckle fractures
- Femoral shaft fractures in toddlers (Correct answer)
- Medial epicondyle avulsion fractures
- Clavicle fractures in neonates
Correct answer: Femoral shaft fractures in toddlers
Femoral shaft fractures in toddlers are managed with overhead traction to provide adequate alignment and immobilization without surgical intervention.
Question 4: If a patient's traction rope slips off the pulley, the PRIORITY action is to:
- Document the event and wait for the next scheduled assessment
- Replace the rope on the pulley and verify alignment and weight (Correct answer)
- Increase the traction weight to compensate for lost force
- Place the patient in a splint until the rope is repaired next day
Correct answer: Replace the rope on the pulley and verify alignment and weight
A displaced traction rope eliminates the therapeutic force, risking fracture displacement; it must be promptly replaced and the setup verified.
Question 5: Which of the following BEST describes the purpose of counter-traction?
- To apply a second traction force in the same direction as the primary traction
- To provide an opposing force that prevents the patient from sliding toward the weights (Correct answer)
- To correct rotational deformity independent of longitudinal pull
- To elevate the injured limb for edema control only
Correct answer: To provide an opposing force that prevents the patient from sliding toward the weights
Counter-traction is an equal and opposite force—usually the patient's own body weight—that resists the traction pull and maintains net force across the fracture site.
Question 6: When troubleshooting ineffective traction, which factor should be assessed FIRST?
- Whether the patient requires stronger analgesics
- The integrity and alignment of the entire traction setup including ropes, pulleys, and weights (Correct answer)
- Whether the fracture has healed sufficiently to discontinue traction
- The patient's nutritional status and serum calcium level
Correct answer: The integrity and alignment of the entire traction setup including ropes, pulleys, and weights
Equipment integrity—ropes not fraying, pulleys rotating freely, weights hanging freely without touching the floor—must be confirmed before assuming a clinical cause for ineffectiveness.
Question 7: Which documentation element is MOST critical to record after each neurovascular check of a traction patient?
- The total number of pillows used for positioning
- Pulse quality, capillary refill, sensation, and motor function distal to the traction (Correct answer)
- The patient's pain score before and after analgesic administration only
- The brand name of the traction foam boot in use
Correct answer: Pulse quality, capillary refill, sensation, and motor function distal to the traction
A complete neurovascular assessment—pulse, capillary refill, sensation, and motor function—provides the baseline needed to detect early deterioration and guide timely intervention.
OTC Orthopaedic Technologist Certified Traction Principles and Application 5
Traction is generally contraindicated in which of the following scenarios?