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Gently lift the straightened leg and pull it away from the patient’s body in the direction of their sole.  Apply traction starting at, but not above, the fracture line. Run strapping down one side of the leg, around a 3-inch (7.5 cm) spreader, and up the other side of the leg. The spreader should extend approximately 6 inches (15 cm) beyond the end of the patient’s leg. The extra strap beneath the foot will appear like a loose stirrup. Instead of a spreader, your facility may be equipped with a foam and metal stirrup that can be bent around the heel and ankle of the injured leg and wrapped onto the strap. At this point, you will carefully wrap the leg in crepe wrapping or gauze. As you do so, pad the sides of the ankle and any other bony areas, such as the sides of the knee. Wrap the leg in alternative spirals instead of consistent circles to reduce tightness.  Start at the ankle and move upward in slow, even rotations.  Conclude the wrap just before the end of the adhesive strip. The bandage should not go past the fracture. If using a stirrup, make sure it is also wrapped securely into place above the traction tape. Usually, skin traction is used in tandem with weight resistance that helps apply pressure to the leg through the adhesive strip.  If you’re using weights as well, elevate the leg. If possible, do so by elevating the end of the bed where the leg is resting. Once elevated, attach a traction cord through the spreader at the midpoint of the adhesive tape. If weighted skin traction is to be used, a doctor will have prescribed a specific amount of weight to be attached to the end of the traction cords.  Depending on the injury, this traction cord may run over the end of the bed with the weights hanging below.  Alternatively, some scenarios may call for the use of pulley systems, with the weight on one side and the suspended leg on the other.  Never exceed 11 lbs. (4.99 kg) of weight. You may need to shorten the traction cord to ensure that the weight is suspended in the air, as opposed to resting on the floor or bed.
Apply traction strapping. Pad the ankles while wrapping the leg. Elevate the leg. Apply weighted resistance as prescribed.