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2Application of traction

Patient positioning for traction of a distal tibia fracture

The fracture is aligned, and reduction is maintained by applying 3-5 kg traction through an appropriate clamp on the pin or K-wire. Mild to moderate elevation of the injured limb helps control swelling. Adequate padding under the calf, to avoid heel pressure, is necessary to avoid skin breakdown. Trendelenburg positioning provides counter traction and prevents the patient from sliding down the bed. Traction should not be maintained longer than necessary, i.e., until local soft-tissue situation permits definitive treatment.

The supporting frame or pin/wire clamp should not compress the skin.