title: Indications and anatomic landmarks for the application of lower extremity traction: a review.
abstract: OBJECTIVE
  Fractures of the lower extremity, particularly of the femur and acetabulum, may be difficult to immobilize with splinting alone. These injuries may be best stabilized with the application of various types of skeletal traction. Often, traction is applied percutaneously in an emergent setting, making the knowledge of both superficial and deep anatomy crucial to successful placement.
  
  
  METHODS
  Review was performed via PubMed search as well as referencing the Orthopaedic literature. Relevant articles to the anatomy of the knee, ankle and calcaneus as they pertain to traction placement were referenced in compiling the optimal recommendations for traction placement.
  
  
  CONCLUSIONS
  By palpating and marking superficial landmarks and observing specific anatomic relationships, safe application of traction pins can be performed while minimizing iatrogenic injury to vital anatomic structures, and avoiding intra-articular placement which could potentially lead to joint infection.
authors.affiliation: Department of Orthopaedics, Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA. sdefroda@gmail.com.
authors.forename: S F
authors.identifier: http://orcid.org/0000-0001-8518-5371
authors.initials: SF
authors.lastname: DeFroda
authors.affiliation: Department of Orthopaedics, Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Gil
authors.affiliation: Division of Orthopaedic Trauma, Department of Orthopaedics, Alpert Medical School at Brown University, Providence, RI, USA.
authors.forename: C T
authors.initials: CT
authors.lastname: Born
mesh_terms: D059925:Anatomic Landmarks; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D007869:Leg Injuries / Q000628:therapy*; D010173:Palpation; D014143:Traction
keywords: Fracture; Lower extremity; Skeletal traction; Trauma