Page 38 - Orthopedic Casts and Splints2

Performance Steps

19. Secure (2) pulley attachments to the center clamp bar approximately 10 inches apart.
20. Tie traction cord to spreader bar, block and weight carrier.
a. Remove 8-12 feet of traction cord from the spool.
b. Cut traction cord at measured length.
c. Tie a non slip knot to the end of the spreader bar.
d. Thread opposite end of traction cord through the pulley above the injured knee to the top
pulley attached to the center clamp at the foot of the bed, to the spreader block, and ending
through the bottom pulley attached to the center clamp.
e. Tie a non slip knot to the weight carrier.
21. Place pillow lengthwise under injured leg.
CAUTION: If a pillow is ordered , it must remain in place. Removing the pillow can change the vectors
of force alignment.

NOTE: The pillow may need to be adjusted throughout the application to obtain 25-35 degrees of knee
flexion.
22. Apply weight plates to the weight carrier.
CAUTION: Always inform patient prior to adding or removing weight plates.
NOTE: Physician's order will determine specific amount of weight plates needed.

NOTE: With the vector of force principle, the actual horizontal pulling force on the extremity is double
the amount of applied weight, while the lift is equal to the actual weight.
23. Elevate or raise the foot of the bed
NOTE: If bed is non electric manually raise(gatchet) the foot of bed. If bed is electric press button on
control panel.

NOTE: The bed is elevated or raised to provide counteraction which will assist in alignment of the
fracture(s)

24. Measure injured knee with goniometer.
a. Place the stationary arm of the goniometer horizontally , bisecting the lateral aspect of the
femur.
b. Place the moving arm of the goniometer horizontally, bisecting the lateral aspect of the fibula.
c. Place the protractor of the goniometer on the lateral aspect of the knee.
d. Set knee until the goniometer measure between 25-35 degrees of flexion.
NOTE: If angle is less than 25 or more than 35 degrees, remove weight plates, go to steps 21, 22, 23,
24.
25. Check and adjust alignment of traction equipment.
a. The 18 inch single clamp bar is proximal to the patient's injured knee
b. Pulley attachment is aligned with the injured knee.
c. 9 inch single clamp at the foot of bed is medial to the injured leg.
d. 9 inch single clamp bar is secured (horizontally) to the distal end of the clamp bar in 26 c.
e. Center clamp bar is aligned to injured leg.
f. (2) pulley attachments are approximately 10 inches apart.
NOTE: Adjust traction equipment as needed.

26. Check patient's capillary refill of both feet.
CAUTION: Prior to starting and finishing any procedure on a patient, circulation is always checked.
a. Squeeze patient's toes and the nail beds turn white.
b. Release patient's toes and the nail beds will return pink.

35