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3Reduction and preliminary fixation

Manual traction

Manual traction

Depending on the patient’s positioning and type of OR table, one or two people may be required to perform manual traction.
The illustration shows a triangular radiolucent supporting frame, with padding over top, placed proximal to the popliteal fossa. It provides “countertraction” when the fracture is lengthened with distal traction.

For patients positioned on a radiolucent table without knee support, one person holds the leg and the other pulls the leg distally.
During traction, the reduction is controlled by palpating the tibial crest and the anteromedial surface.