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The problem in treating oblique fractures of the tibia is in maintaining the reduction of the fragments—in other words, traction. The physiologic position is that in which the desiderata are most easily maintained and the objectionable muscle action is best avoided. Sixty degrees' flexion of the knee and 90 degrees of ankle is the position of choice. It is impossible to hold the foot by hand in the correct position while applying plaster.
There is at present no apparatus that offers the following requirements: With flexion of the knee and dorsiflexion of the ankle, (1) to overcome overriding from muscle pull; (2) to obtain countertraction as well as traction; (3) to prevent rotation of the lower fragments; (4) to control eversion and inversion of the foot; (5) to control angulation and lateral displacements, and (6) to permit free application of plaster on obtaining all these corrections and to maintain the
Oppenheimer ED. IMPROVED METHOD OF TREATING OBLIQUE FRACTURE OF THE TIBIA. JAMA. 1922;79(10):822-823. doi:10.1001/jama.1922.26420100001014