• Immobilise femoral fractures.
  • Ankle or foot fracture
  • Fracture to the proximal third of the femur
  • Neck of femur fracture
  • Pelvic fracture
  • Significant knee injury
  • Supracondylar fracture of the distal end of the femur
Patient Factors & Considerations
  • Assess distal neurovascular observations:
    • Pulse, Colour / Warmth / Movement / Sensation (CWMS)
  • Compound fractures.
  • Do not apply leg straps over knee as this will cause misalignment and pain.
  • Procedure is under the control of the person applying manual traction.
  • All relevant infection control methods to be utilised.
  • Prepare splint.
  • Explain the procedure to the patient.
  • Consider appropriate analgesia.
  • Expose the injured leg completely, examine leg, check for pedal pulses, motor and sensory function.
  • Apply manual inline traction.
  • Measure splint to the correct length by placing flat next to the patient’s uninjured leg.
  • Extend so that the patient’s heel is approximately 10cm above the heel stand bracket.

  • Dress open fractures and wounds.
  • Wrap the ankle harness around the patient’s ankle with additional padding and apply the velcro strapping.
  • Ensure traction is maintained by second person, adjust the ankle harness so the foot is central and the end of the traction strap is aligned with the malleoli.
  • Apply the splint under the injured leg up to the ischial fold.
  • Fasten the ischial strap.
  • Pull the traction release ring to loosen the ratchet strap, bring the S hook over the top of the splint and attach it to the D ring.
  • Turn the traction knob to replace manual traction. Ensure ankle harness is directly under the ankle and allow the ankle to rest on harness.
  • Reposition and fasten the leg straps ensuring they do not cover any section of the injury.
  • Transfer the patient onto the stretcher for transportation.
  • Ensure the splint is elevated by the heel stand.

Shortening the splint

  • Re-apply manual traction to the leg by holding on to the extension straps at the back of the ankle while using the other hand to release the traction ratchet.
  • Second officer is to loosen both locking collars in the anticlockwise direction simultaneously.
  • The person in control of the traction is to operate the ratchet by shortening the ratchet strap to about 75mm before the S hook, the telescopic tubes will shorten inward. Beware of obstacles in the way of the heel stand.
  • Re-tighten the locking collars simultaneously and check traction.
Additional Information
Additional information


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