Time: 10 mins
Personnel Required: 1-2
Equipment Required:
1. adequate analgesia
2. If adding procedural sedation, end tidal CO2 + monitor
Steps:
1. Operator: Flex hip and knee to 90 degrees.
2. (Optional) Assistant: Provide countertraction at the knee.
3. Operator: Dorsiflex the foot to disengage the talus.
4. Operator: Apply axial traction.
5. Operator: Push heel backward while pulling the tibia anteriorly.
6. Operator: Plantarflex the foot.
7. Splint: Posterior short leg with stirrups. Keep ankle at neutral position, 90% to leg.
Time: 10 mins
Personnel Required: 2
Equipment Required:
1. adequate analgesia
2. If adding procedural sedation, end tidal CO2 + monitor
Steps:
1. Operator: Flex hip and knee to 90 degrees.
2. Assistant: Provide countertraction at the knee.
3. Operator: Provide axial traction with one hand on the heel and other hand on dorsum of the foot.
4. Operator: Provide axial traction/countertraction, by recreating the motion of the initial injury before bringing it back to midline.
5. Operator: Check neurovascular exam (DP/PT pulses, cap refill, light touch, pain, motor).
6. Consult Ortho for formal ORIF.
Time: 10 mins
Personnel Required: 1-2
Equipment Required:
1. adequate analgesia
Steps:
1. Operator: Flex hip and knee to 90 degrees.
2. (Optional) Assistant: Provide countertraction at the knee.
3. Operator: Place one hand on the heel and other hand on dorsum of the foot.
4. Operator: Provide axial traction and manipulate medially to bring the ankle back into position.
5. Operator: Check neurovascular exam (DP/PT pulses, cap refill, light touch, pain, motor).
6. Splint: Posterior short leg with stirrups. Keep ankle at neutral position, 90% to leg.
Time: 10 mins
Personnel Required: 1-2
Equipment Required:
1. adequate analgesia
2. If adding procedural sedation, end tidal CO2 + monitor
Steps:
1. Operator: Flex hip and knee to 90 degrees.
2. (Optional) Assistant: Provide countertraction at the knee.
3. Operator: Plantarflex the foot to disengage the talus.
4. Operator: Apply axial traction.
5. Operator: Pull heel forward while pushing the tibia posteriorly.
6. Operator: Dorsiflex the foot.
7. Splint: Posterior short leg with stirrups. Keep ankle at neutral position, 90% to leg.