Where should the femur and tibia pins be placed?

• A. Femur: one hands breadth inferior to pole of patella; Tibia: one hands breadth superior to tibial tubercle
• B. Femur: one hands breadth superior to the greater trochanter; Tibia: one hands breadth inferior to tibial tubercle
• C. Femur: one hands breadth superior to the pole of patella; Tibia: one hands breadth inferior to the tibial tubercle
• D. Femur: one hands breadth superior to pole of patella; Tibia: one hands breadth inferior to the tibial tubercle

Answer: (C)

Placement of skeletal traction pins uses recognizable landmarks to keep pins in safe, effective locations that pull along the bone without entering a joint or risking nearby structures. For the femur, placing a pin about one handbreadth above the superior pole of the patella puts it in the distal femur, just proximal to the knee joint, so traction is aligned with the femur and does not compromise the joint or patellar tendon area. For the tibia, placing a pin about one handbreadth below the tibial tubercle positions it in the proximal tibia, below the tibial tubercle and away from the knee capsule and the common peroneal nerve, allowing safe, direct traction on the tibia. This combination reflects common, safe traction pin sites.