• 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 if resources permit.

Unilateral Fracture

• Position the sager between the patient’s legs and move the uninjured leg away if possible.
• Rest the ischial perineal cushion against the ischial tuberosity with the shortest end of the base towards the ground and towards the same side as the injured leg. If male, the patient’s genitalia to be adjust to the opposite side to prevent trauma.
• If appropriate, place a trauma dressing under the thigh strap for patient comfort. Secure the thigh strap around the upper thigh of the injured limb by holding the splint firmly in place while tightening the strap to ensure a firm but comfortable fit and allow blood circulation.
• Prepare the ankle harness by folding down the required amount of cushioning.
• Wrap the ankle harness snugly around the ankle above the melleoli.
• Place one hand on the ischial perineal cushion, and thumb and index finger of the other hand to be used to bring the spring clip up towards the ischial perineal cushion to release the spring. Lift the spring clip and extend the chrome inner shaft until the crossbar lines up with the patient’s heel.
• Attach the ankle harness strap to the cross bar.
• Adjust the traction straps until tight between the harness and the cross bar.
• Adjust the ankle harness strap until tight between the ankle harness and cross bar, refer to the guide below:
• 10% of patient’s body weight per femur.
• Maximum 7kg per femur for adults and 3.5kg per femur for children.
• Slide the securing straps in under both legs by pushing it in from one side and then pulling it through to the other side.
• As these straps are elastic do not over tighten them, this will cause more pain and discomfort, tighten to provide support.
• Recheck patient before and after any movement. Check distal pulses, pain and motor and sensory functions.
• Adjust traction as per point 4.  If required by maintaining manual traction.
• Slowly adjust to the position desired in the clinical setting or for removal during a training session. Note the potential for pinch points.

Bilateral fracture

• Attach the splint to the side with the greatest degree of injury with the articulating base towards the injured leg.
• Attach additional ankle harness to second leg.
• Secure the figure 8 securing strap or triangular bandage to ankles.

Use lips to lift lock – approach from the ischial pad side to void pinch point