Effectiveness of the Taut-Line Hitch Knot in Reducing and Splinting Lower Extremity Fractures

Techniques for single-provider reductions are valuable methods for provisional stabilization of fractures. In the setting of a lower extremity fracture, these techniques often use stockinette or kerlex to suspend an extremity while a reduction maneuver is performed, cast padding is applied, and a plaster splint is placed with subsequent molding to maintain reduction. Obtaining and maintaining a suitable amount of tension to the soft material while securing the limb to the stretcher or hospital bed continues to make these reduction maneuvers difficult to perform. This challenge is exacerbated in the obese patient population. As such, we describe the adaptation of the taut-line hitch knot in the setting of single-provider reductions. This knot type permits adjustable tensioning of kerlex or stockinette while suspending a limb when force is applied perpendicular to the direction of tension. This facilitates positioning and maintenance of limb suspension during reductions of unstable lower extremity injuries.