Barrel Sling Technique for Ankle Traction

BACKGROUND

The conventional method to provide traction at the ankle joint has invariably involved the use of manual or percutaneous calcaneal traction, or expensive, disposable devices. We present here an inexpensive, easy to apply, alternative method, once a handy favourite with sea men shifting cargoes. The Barrel Sling Technique, using ordinary 6-inch sterile crepe bandage, is an ingenious method to provide traction at the ankle joint, used for procedures such as ankle arthroscopies and minimally invasive plate osteosynthesis of tibial fractures.

TECHNIQUE

With the patient supine, the centre of the bandage cradles the tendo-Achilles. The arms of the bandage are wrapped around the ankle crossing over on the dorsum of the foot (Fig. 1). The throws are then brought around the foot sole and made to cross each other again (Fig. 2). The two arms of the bandage are made to pass under the first throw and brought up proximally. Alternate traction to tighten up the construction/sling (Fig. 3). The direction of the traction is now finally reversed so that it is away from the patient (Fig. 4). The axis of traction is then centralised, securing the traction by multiple simple knots inserted between the two free ends of the bandage which is taken over a sturdy bar and 2–7 kg weights applied (Fig. 5).

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

DISCUSSION

This is an easy and secure method of traction; no skin problems have been encountered to date. The obvious advantages are that the technique is: (i) inexpensive (15 p); (ii) easy to apply using readily available material; and (iii) non-invasive for the patient.