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Quizzes > Health & Medicine > Human Anatomy & Medicine

Master the Musculoskeletal Examination Quiz Now!

Put Your Buck Traction Heels with Pillow & Footplate Bucks Traction Knowledge to the Test!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art style showing foot in buck traction with pillow under heel and footplate on teal background

Are you ready to put your clinical acumen to the test with our musculoskeletal examination quiz? Whether you're brushing up on knee exams or delving into specialized techniques like buck traction heels with pillow and footplate bucks traction, this free challenge will sharpen your skills and deepen your understanding. Designed for physiotherapists, students, and healthcare pros, you'll reinforce core concepts and uncover subtle nuances through real-world scenarios. Explore our exam prep guide for extra tips and check out a detailed system assessment to broaden your foundation. Plus, you'll master techniques from footplate for bucks traction to essential evaluation steps, ensuring you're fully prepared for any clinical scenario. Dive in now and prove your expertise!

What is the primary purpose of Buck's traction in lower limb injuries?
Maintain alignment of fractured bones
Increase muscle strength
Improve cardiovascular endurance
Reduce joint range of motion
Buck's traction is a form of skin traction used to maintain proper alignment of fractured bones by applying a steady pulling force, which also helps reduce muscle spasms. It does not involve skeletal pins and aims to immobilize the limb until further treatment. This method stabilizes fractures, usually in the femur or hip region. Physio-Pedia on Buck's Traction
Which component is used to attach weight in skin traction like Buck's traction?
Adhesive straps or traction boot
Intramedullary rod
External fixator
Kirschner wire
In skin traction methods such as Buck’s traction, weights are attached via straps or a specialized traction boot applied to the skin surface without penetrating it. This provides a pulling force to maintain bone alignment. It differs from skeletal traction that uses pins or wires. NCBI Traction Overview
What is the recommended maximum weight for adult Buck's skin traction?
10 pounds
25 pounds
40 pounds
50 pounds
Adult skin traction like Buck’s traction typically uses a weight not exceeding 10 pounds to avoid skin damage. Excess weight can lead to skin breakdown and circulatory compromise. Proper application respects tissue tolerance while providing adequate pull. Nursing Times on Skin Traction
Placing a pillow under the heel during Buck’s traction primarily prevents which complication?
Pressure sores on the heel
Deep vein thrombosis
Osteoporosis
Compartment syndrome
Using a pillow under the heel in Buck’s traction helps offload pressure from the heel, reducing the risk of pressure ulcers. It also supports proper leg elevation without compromising the traction line. Monitoring skin integrity remains essential. Dartmouth on Pressure Ulcer Prevention
Footplate traction supports the foot in which position?
At a right angle to the leg
Full plantarflexion
Full dorsiflexion
Neutral rotation only
Footplate traction uses a rigid plate to hold the foot at approximately 90 degrees relative to the leg, ensuring even distribution of traction forces through the foot and ankle. This position aids in maintaining alignment and preventing foot drop. Physio-Pedia Foot Traction
How often should skin under traction be inspected for breakdown?
Every 4 hours
Once daily
Only if patient complains of pain
Every 12 hours
Skin under traction must be inspected at least every 4 hours to detect early signs of breakdown or pressure ulcers. Frequent checks help identify issues before they become severe. Documentation of skin condition is vital for ongoing care. Nursing Times Skin Care
Which type of traction involves applying force through the skin without bone penetration?
Skin traction
Skeletal traction
Balanced suspension
Halo traction
Skin traction applies pulling force using strips, boots, or adhesive materials on the skin surface without penetrating bone. Skeletal traction, by contrast, uses pins or wires affixed to bone. Balanced suspension is a specialized skeletal method. NCBI Traction Overview
What patient position is ideal when using Buck’s traction on the lower limb?
Supine with slight hip flexion
Prone with knee flexion
Side-lying with hip abduction
Fowler’s with knee extension
In Buck’s traction for lower limb injuries, the patient is positioned supine with slight hip flexion and the leg extended to align the pulling force with the femur’s axis. This position reduces muscle tension and maintains traction efficacy. Physio-Pedia on Buck's Traction
Buck’s traction is most commonly used to treat which of the following injuries?
Femoral neck fractures
Distal radius fractures
Clavicle fractures
Spinal compression fractures
Buck’s traction is frequently applied in management of hip and femoral neck fractures to stabilize and align the fracture site preoperatively. It is not typically used for upper limb or spinal fractures. Physio-Pedia on Hip Fracture
What is a key benefit of skin traction compared to skeletal traction?
Lower risk of infection
Higher weight tolerance
Permanent fracture stabilization
Invasive fixation
Skin traction carries a lower infection risk because it does not involve bone penetration, unlike skeletal traction which uses pins or wires. However, skin traction tolerates less weight. It is best for short-term alignment. NCBI Traction Overview
What complication is minimized by using a heel suspension pillow in footplate traction?
Heel pressure ulcers
Pulmonary embolism
Osteomyelitis
Hypotension
A pillow under the heel in footplate traction lifts the heel off the bed surface, preventing pressure ulcer formation by reducing direct pressure and enhancing skin perfusion. Regular repositioning complements this practice. Dartmouth on Pressure Ulcer Prevention
Effective traction requires the line of pull to be:
Colinear with the long axis of the bone
Perpendicular to the fracture site
At a 45° angle to the limb
Directed toward the head only
Traction works best when the pulling force is aligned with the long axis of the bone, ensuring proper reduction and stabilization of the fracture. Misalignment can reduce effectiveness and increase tissue strain. Physio-Pedia on Traction Principles
Which sign indicates that Buck’s traction may not be functioning correctly?
Traction rope touching the floor
Patient reports no pain
Weights suspended freely
Leg is in neutral position
If the traction rope touches the floor, the weights cannot exert proper pull, indicating a disruption in traction setup. The rope should remain suspended with weights freely hanging. Regular checks of the rope position ensure efficacy. Nursing Times Traction Setup
In footplate traction, the foot is positioned at approximately what angle to the leg?
90 degrees
45 degrees
120 degrees
0 degrees
Footplate traction maintains the foot at about 90 degrees relative to the leg, which helps distribute traction forces evenly and prevents plantarflexion contractures. This setup also supports proper alignment. Physio-Pedia Foot Traction
When assessing a patient in traction, neurovascular status must be checked every:
2 hours
6 hours
12 hours
Once daily
Neurovascular checks including pulses, capillary refill, sensation, and movement should be performed every 2 hours in traction to detect early signs of compromised circulation or nerve injury. Prompt intervention prevents serious complications. Nursing Times Neurovascular Assessment
How does footplate traction differ from traditional Buck’s skin traction?
It uses a rigid plate under the foot instead of straps
It penetrates the bone for fixation
It only treats upper limb fractures
It eliminates the need for weights
Footplate traction employs a rigid footplate to support and apply traction across the ankle and foot, in contrast to Buck’s traction which uses straps or a boot on the skin. Both are skin traction methods but differ in attachment. Physio-Pedia on Traction Methods
When applying Buck’s traction, the weight should be attached to:
A rope over a pulley at bed level
The head of the bed directly
Under the mattress
A fixed bar on the wall
The weight in Buck’s traction is attached to a rope running over a pulley aligned with the foot of the bed. This setup ensures the force remains colinear with the limb. Incorrect attachment points compromise traction force. NCBI Traction Overview
Which of the following is a contraindication to applying skin traction?
Skin infection at traction site
Stable closed fracture
Mild muscle spasms
Patient obesity
Skin traction should not be applied over an area of skin infection or open wounds because it may worsen the condition and risk systemic infection. Alternative methods or skeletal traction may be indicated. NCBI Traction Complications
In skeletal traction, which structure is directly used to attach weights?
Kirschner wire or Steinmann pin
Adhesive bandages
Traction boots
Elastic wraps
Skeletal traction involves insertion of a Steinmann pin or K-wire through the bone, to which weights are attached, allowing greater weights and more precise control. This differs from skin traction which uses only adhesive or boot methods. Physio-Pedia Skeletal Traction
Which sign is an early indicator of compartment syndrome in a limb under traction?
Pain out of proportion to injury
Absence of pedal pulse
Swelling beyond the traction site
Bruising at traction site
Severe pain disproportionate to examination findings is the earliest sign of compartment syndrome and warrants immediate evaluation. Pulses may remain present early on. Early detection prevents permanent damage. AAOS on Compartment Syndrome
How often should traction weights and pulley alignment be checked?
Every shift (at least every 8 hours)
Once per day
Only when the patient complains
Weekly
Traction systems should be checked every nursing shift, at minimum every 8 hours, to ensure weights hang freely and pulleys remain aligned. This prevents loss of traction force and potential complications. Nursing Times Traction Care
What type of exercise is commonly prescribed to patients in traction to prevent muscle atrophy?
Isometric muscle contractions
Heavy resistance training
Running in place
Deep squats
Isometric exercises, such as quadriceps sets, help maintain muscle tone and minimize atrophy without moving the joint, which could disrupt traction. These exercises are safe and effective during immobilization. Physio-Pedia on Isometrics
Which neurovascular check finding requires immediate intervention in a patient with limb traction?
Progressive paresthesia and pallor
Mild transient numbness
Normal capillary refill
Warm skin temperature
Progressive numbness, tingling, and pallor suggest compromised circulation or nerve compression and necessitate urgent assessment. Early recognition can prevent irreversible damage. Nursing Times Neurovascular Assessment
What is the main advantage of balanced suspension traction over simple skin traction?
Allows mobility of the patient in bed
Uses no weights
Is noninvasive
Requires fewer pulleys
Balanced suspension uses multiple ropes and pulleys that support the limb in air, allowing some patient mobility and easier repositioning while maintaining traction. It also distributes weight forces more evenly. Physio-Pedia Skeletal Traction
Which finding indicates adequate footplate traction setup?
Foot remains aligned with traction rope in a straight line
Foot rotates laterally
Pillow under heel collapses completely
Rope swings freely across the bed
Proper footplate traction maintains the foot, plate, and rope in one straight line to ensure continuous pull. Any misalignment reduces the traction force and may worsen the injury. Physio-Pedia Foot Traction
What is the primary reason for applying traction underwear or a trapeze bar in traction care?
To assist patient repositioning and reduce shearing forces
To increase traction weight capacity
To measure limb circumference
To secure weights to bed frame
Traction underwear or trapeze bars allow patients to reposition themselves in bed, reducing shearing forces on the skin and enhancing comfort. They do not alter the traction force. Physio-Pedia Traction Equipment
Which vascular complication must be monitored in a patient on prolonged lower limb traction?
Deep vein thrombosis
Arterial embolism
Varicose veins
Lymphedema
Prolonged immobilization in traction increases the risk of deep vein thrombosis due to venous stasis. Regular assessment and prophylactic measures like compression devices are recommended. NCBI on DVT Prevention
What precaution should be taken when increasing traction weight?
Increase in small increments while monitoring skin and neurovascular status
Double the previous weight immediately
Remove all existing weights first
Only increase if patient requests
When adjusting traction weight, small incremental increases allow monitoring for skin integrity and neurovascular compromise. Sudden large increases risk tissue damage and circulatory issues. Physio-Pedia Traction Guidelines
In footplate traction, which assessment ensures the traction force remains constant?
Checking that the foot remains in contact with the plate and weights hang freely
Measuring calf circumference daily
Observing patient sleep position
Assessing joint range of motion
Ensuring the footplate remains in proper contact with the sole of the foot and that the weights hang freely confirms continuous and constant traction force. Any gap or obstruction disrupts traction. Physio-Pedia Foot Traction
Which sign requires repositioning of a traction boot or strap?
Skin redness under the strap
Patient reports no discomfort
Weights remain steady
Pulley alignment is correct
Redness under a traction strap indicates excessive pressure or improper fit, requiring repositioning to prevent skin breakdown. Continuous assessment and adjustment help maintain skin integrity. Nursing Times Skin Care
Which biomechanical principle best explains why Buck's traction reduces muscle spasms?
Sustained low-load stretch inhibits reflex muscle contraction
High-load intermittent stretch enhances strength
Compression increases blood flow
Axial rotation realigns muscle fibers
Sustained low-load stretching provided by traction decreases muscle spindle activity and inhibits reflex contractions, thus reducing spasms. This principle underlies traction’s analgesic effect in fractures. Physio-Pedia Biomechanics
What measure helps prevent skin breakdown under traction straps in a patient with fragile skin?
Apply foam padding under straps
Use heavier weights
Reduce traction angle
Increase friction at skin interface
Foam padding distributes pressure evenly and reduces shear, protecting fragile skin under traction straps. Proper cushioning is key in patients at high risk for breakdown. NCBI Traction Complications
During radiographic evaluation of a patient in Buck’s traction, which finding indicates adequate fracture alignment?
Cortical continuity without significant angulation
Widened fracture gap
Overlapping bone fragments
Significant rotational deformity
Radiographs showing cortical edges aligned with minimal angulation indicate good reduction. Overlap or gaps suggest loss of traction effect. Imaging guides ongoing management. Radiopaedia on Femoral Neck Fracture
When might conversion from skin traction to skeletal traction be indicated?
When greater weight is needed for fracture reduction
If skin traction fully reduces the fracture
To lower infection risk
In minor sprains only
Skeletal traction is indicated when higher loads are required to achieve and maintain reduction, such as with displaced fractures unresponsive to skin traction. It provides stronger, more controlled force. Physio-Pedia Skeletal Traction
A patient in Buck’s traction reports increased proximal thigh pain despite correct setup. What is the most appropriate next step?
Assess for skin breakdown, perform neurovascular exam, and evaluate traction weight
Immediately remove all traction weights
Apply heat packs to the thigh
Encourage heavy weight-bearing exercises
New or worsening pain may signal skin breakdown, neurovascular compromise, or improper traction weight. A comprehensive assessment ensures patient safety and effective traction. Nursing Times Traction Complications
How is the vector of force calculated in a balanced suspension system?
By summing the directional components of all applied tensions
By measuring pulley diameter only
By patient weight alone
By contact area of traction straps
The net traction force vector is determined by adding the individual tension components from each rope and pulley, using vector addition. This ensures balanced, continuous pull. Physio-Pedia Biomechanics
Which laboratory finding may indicate fat embolism syndrome in a patient on lower limb traction?
Hypoxemia and petechial rash with altered mental status
Elevated white blood cell count only
Hyperglycemia
Decreased creatinine kinase
Fat embolism presents with respiratory distress (hypoxemia), neurological changes, and petechial rash. Early recognition in the context of long bone fractures and traction is essential. NCBI on Fat Embolism Syndrome
What is the role of a continuous passive motion (CPM) device in conjunction with traction?
Promote joint mobility and prevent stiffness during immobilization
Increase traction force gradually
Replace the need for weights
Seal incision sites completely
CPM devices gently move the joint through a controlled range of motion, helping maintain cartilage health and preventing stiffness while traction immobilizes the limb. They do not affect traction mechanics. Physio-Pedia CPM
Which change in skin condition beneath traction straps necessitates immediate removal and reevaluation?
Blister formation or open wound
Faint pink coloration
Slight warmth
Minimal hair loss
Blisters or open wounds under straps indicate excessive shear or pressure, requiring traction removal and repositioning to prevent infection and further tissue injury. Ongoing monitoring is critical. Nursing Times Skin Care
When using traction, what factor most directly affects the magnitude of the pulling force?
Weight applied hanging freely
Length of the traction boot
Color of the straps
Bed elevation alone
The pulling force in traction is directly proportional to the weight suspended and the line of pull. Other factors like boot design influence distribution but not magnitude. Physio-Pedia Biomechanics
In managing a patient with footplate traction, which electrolyte imbalance should be closely monitored due to immobilization?
Hypercalcemia
Hypernatremia
Hypokalemia
Hyponatremia
Prolonged immobilization can lead to increased bone resorption and hypercalcemia, requiring monitoring of serum calcium levels. Early detection prevents complications such as renal stones. NCBI on Immobilization Effects
Which formula correctly calculates the vector sum of two traction forces applied at 30° and 60° to the limb axis, respectively?
Resultant = ?(F1² + F2² + 2·F1·F2·cos30°)
Resultant = F1 + F2 always
Resultant = F1·sin60° - F2·cos30°
Resultant = F1² - F2²
The vector sum of two forces uses the law of cosines: ?(F1² + F2² + 2·F1·F2·cos?). Here ? is the angle between forces, with 30° between them in this configuration. This calculates the true resultant traction force. Wiki on Law of Cosines
Compared to Hamilton-Russell traction, Buck’s traction offers which advantage?
Less complex setup with fewer pulleys
Ability to apply higher longitudinal forces
Requires skeletal pin insertion
Supports full weight-bearing ambulation
Buck’s traction is simpler, using a single pulley and weight, whereas Hamilton-Russell is a balanced suspension with three points of pull and more pulleys. Hamilton-Russell allows multi-directional force but is more complex. Physio-Pedia Balanced Suspension
According to current evidence-based guidelines, what is the maximum recommended duration for continuous skin traction in adults before reassessment?
48–72 hours
24 hours
One week
No limit if skin intact
Evidence-based protocols suggest continuous skin traction be reassessed at least every 48–72 hours to prevent skin complications and verify alignment. Extended unmonitored use increases risks. NCBI Traction Guidelines
Meta-analysis data indicate that pillow heel suspension reduces pressure ulcer incidence by roughly what percentage compared to standard traction setup?
Approximately 60%
10%
25%
90%
Studies show that elevating the heel on a pressure-relief pillow beneath footplate traction can reduce ulcer risk by about 60% by offloading pressure points. This is a key preventive strategy. PMC Heel Offloading Study
What is a novel traction method emerging for femoral fractures that combines external fixation with dynamic tensioning?
Hybrid robotic-assisted traction systems
Cerclage wire traction
Traditional balanced suspension
Halo-gravity traction
Hybrid robotic-assisted traction systems are at the forefront of fracture management, offering precise dynamic tensioning combined with external fixators to optimize alignment and reduce manual setup errors. Early clinical trials show promise. PMC Robotic Traction
In a randomized controlled trial, continuous passive motion added to footplate traction resulted in which outcome compared to traction alone?
Improved joint range by 15° at 4 weeks
No difference in healing time
Higher infection rates
Reduced traction effectiveness
RCT data demonstrate that adding CPM to footplate traction improves knee range of motion by about 15° over traction alone at 4-week follow-up, without compromising fracture alignment. This supports combined therapy. PMC on CPM and Traction
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Study Outcomes

  1. Identify Assessment Techniques -

    Recognize each step in the musculoskeletal examination quiz, including key maneuvers for evaluating lower limb traction setups.

  2. Describe Buck Traction Setup -

    Explain the correct procedure for positioning buck traction heels with pillow to ensure patient comfort and effective traction.

  3. Apply Footplate for Bucks Traction -

    Demonstrate proper placement and securing of the footplate for bucks traction to maintain optimal alignment.

  4. Analyze Clinical Scenarios -

    Interpret quiz case studies to identify common pitfalls and select best practices in traction management.

  5. Evaluate Knowledge Proficiency -

    Assess your performance through quiz scores to pinpoint strengths and areas for improvement in musculoskeletal assessment skills.

Cheat Sheet

  1. Buck Traction Heel Positioning -

    When preparing for the musculoskeletal examination quiz, recall that buck traction heels with pillow require the heel to hover on a soft pillow with 20 - 30° of knee flexion to reduce pressure and ensure gentle traction (AAOS recommendation). Proper alignment prevents skin breakdown and maintains effective traction force.

  2. Footplate for Bucks Traction Alignment -

    Position the footplate for bucks traction so the ankle is in neutral dorsiflexion, aligning the Achilles tendon with the traction vector to prevent varus or valgus stress. A simple tip is to use a 90° angle marker drawn on the cast to verify neutral alignment during setup.

  3. Calculating Traction Force -

    Apply 5 - 7% of the patient's body weight in pounds for effective buck traction; for example, a 160 lb patient needs about 8 - 11 lb of traction. Mnemonic trick: "Five to Seven Holds Heaven" helps remember the percentage guideline.

  4. Skin Integrity and Pressure Monitoring -

    Inspect pressure points under the heel and around the footplate every 2 hours, as noted in NIH guidelines, to prevent ulcers or ischemia. Incorporate gentle heel lifts or egg-crate padding under the pillow to redistribute pressure.

  5. Neurovascular Assessment with 5 P's -

    Regularly check Pain, Pallor, Pulse, Paresthesia, and Paralysis to ensure circulation distal to the traction site remains uncompromised. Use the mnemonic "Please Pay Particular Attention to Perfusion" to solidify these critical neurovascular checks.

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