Use of a stockinette in closed reduction of distal extra-articular tibia fractures

Tibia fractures are common orthopaedic injuries. One of the most difficult tibia fractures that physicians encounter is the extra-articular distal third fracture. Operative fixation has certain risks depending on the procedure. Intramedullary nails fail to obtain adequate distal locking, and plate fixation increases the risk of soft tissue complications. Therefore, when indicated, closed reduction should be attempted. We have devised a method of applying in-line traction while performing closed reduction and casting with the use of a stockinette. This method avoids many of the problems encountered with other techniques such as calcaneal traction pins and hair splints. With the use of in-line traction through the stockinette, we are able to apply traction throughout casting without assistance, and the procedure is noninvasive.