When should you apply traction to a splinted extremity?

Applying traction to a splinted extremity is primarily indicated when there are signs of perfusion or neurological function in the affected limb. This is essential because the presence of blood flow and nerve function suggests that the limb is viable, meaning that it can benefit from the alignment and stabilization that traction provides. Traction is used to minimize movement at the fracture site, alleviate pain, and improve stability. Ensuring perfusion and neurological function assures that the limb is not only alive but also that any realignment performed will not further compromise blood flow or nerve integrity.

In cases where there is severe swelling of the extremity, the focus would typically be on managing that condition rather than applying traction, as it could exacerbate pain and impede circulation. Similarly, applying traction immediately after splinting may not be advisable, as the splint is designed to stabilize the limb first before any additional measures like traction are taken. Pain expressed by the patient is a critical factor in assessment, but it alone does not justify the application of traction without confirming that the extremity is still receiving adequate perfusion and retains neurological function.