# Traction Methods in Orthopaedics

> NEET-PG Orthopaedics traction methods cover skin versus skeletal traction, Gallows, Hamilton Russell, Dunlop and Perkins traction, with indications.

- Canonical URL: https://prepelephant.com/topics/neet-pg/orthopaedics/traction-methods-in-orthopaedics
- Exam / course: NEET-PG · Subject: Orthopaedics
- Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team
- First published: 2026-10-14
- Last updated: 2026-10-14
- Reference basis: Maheshwari's Essential Orthopaedics; Campbell's Operative Orthopaedics; Apley's System of Orthopaedics and Fractures
- How to cite: "Traction Methods in Orthopaedics", PrepElephant, https://prepelephant.com/topics/neet-pg/orthopaedics/traction-methods-in-orthopaedics

## Direct answer

Traction is a continuous pulling force applied to a limb to reduce, align or hold a fracture until fixation or union. Skin traction uses adhesive strapping and light loads for short periods, while skeletal traction passes a pin or wire through bone to carry heavier and longer loads. Classic named methods include Gallows, Hamilton Russell, Dunlop and Perkins traction.

## What you must remember

- **Skin traction:** adhesive strapping applies light, short-term force, and blisters, pressure sores and skin necrosis are its typical complications.
- **Skeletal traction:** a Steinmann or Denham pin, or a wire, transmits heavier force for longer, with pin-track infection and loosening as the main risks.
- **Gallows traction:** both legs hang vertically from an overhead frame with the buttocks just clear of the bed, used for femoral shaft fractures in young children.
- **Hamilton Russell traction:** a sling supports the knee while a pull through the ankle is opposed by the patient's body weight, a method classically cited for hip and femoral injuries in adults.
- **Dunlop traction:** forearm skin traction with a broad sling round the upper arm, used in children chiefly to maintain reduction of supracondylar humerus fractures.
- **Perkins traction:** skeletal traction for femoral shaft fractures through a pin placed in the proximal tibia.
- **Purpose:** traction is a temporary measure, and it has become less common as surgical fixation has advanced.

## Choosing and comparing the traction methods

Traction is classified first by where the force is applied, to skin or to bone, and then by the named method. The table below sets out the classic applications, which examiners often test by pairing a method with its fracture.

| Method | Applied to | Classic use |
|---|---|---|
| Skin traction | Adhesive strapping | Light, short-term traction |
| Skeletal traction | Pin or wire through bone | Heavier, prolonged traction |
| Gallows | Both legs, overhead frame | Femoral shaft in young children |
| Hamilton Russell | Ankle loop, knee sling | Hip and femoral injuries in adults |
| Dunlop | Forearm and arm sling | Supracondylar humerus in children |
| Perkins | Pin in proximal tibia | Femoral shaft fractures |

The distinction that matters most is the load. Skin traction is cheap and easy but cannot safely carry a heavy pull, so skeletal traction is chosen when the fracture needs a larger force for longer.

Gallows and Hamilton Russell traction both rely on the patient's body weight as counter-traction. This suits patients who can be kept in bed, with the trunk acting as the fixed point. Dunlop and Perkins traction are the named methods most often matched to a specific fracture in examination questions, so the pairing deserves rote learning. Each method is a temporary bridge to definitive treatment rather than a substitute for it.

## Where the exam tries to catch you

Traction questions are usually decided by the named method and what it can and cannot do alone.

- **Trap:** believing Dunlop traction reduces a supracondylar humerus fracture by itself. **Correct:** it maintains reduction and lets swelling settle, but manipulation is still needed to achieve reduction.
- **Trap:** using skin traction for a heavy, prolonged pull. **Correct:** skeletal traction through a pin or wire is the choice when a larger force is needed for longer periods.
- **Trap:** choosing Gallows traction for an older child's femoral shaft fracture. **Correct:** Gallows traction is the classic method for young children, where body weight provides adequate counter-traction.

## Frequently asked questions

### Which traction is used for supracondylar humerus fractures in children?

Dunlop traction, a forearm skin traction with a sling round the upper arm, is the classic method used in children with supracondylar humerus fractures. It is used mainly to maintain reduction and allow swelling to settle. It does not reduce the fracture by itself, so manipulation is still required.

### What is the difference between skin traction and skeletal traction?

Skin traction applies a light force through adhesive strapping and is used for short periods. Skeletal traction applies a heavier, longer-lasting force through a pin or wire passed through bone. Skeletal traction carries greater risk of pin-track infection and pin loosening.

### Which traction is classically used for femoral shaft fractures in young children?

Gallows traction is the classic method for femoral shaft fractures in young children. Both legs hang from an overhead frame, with the buttocks just clear of the bed, so that body weight supplies the counter-traction. It is temporary and generally replaced by fixation once feasible.

### Why is Hamilton Russell traction used for hip injuries?

Hamilton Russell traction uses a sling under the knee and a pull through the ankle, with the patient's body weight providing counter-traction. It allows the patient to move in bed while the limb stays under traction. It has been used as a temporary measure for hip and femoral injuries in adults, though surgical fixation has largely replaced it.