Position the Sager SX404 between the patient’s legs, resting the ischial perineal cushion (the saddle) against the ischial tuberosity, with the shortest end of the articulating base towards the ground. In the case of a unilateral fracture, the splint should be placed in the perineum on the side of the injury. In bilateral fractures, excluding pelvic trauma, the side with the greatest degree of injury should be the side of placement. Apply the abductor bridle (thigh strap) around the upper thigh of the fractured limb. Push the ischial perineal cushion gently down while at the same time pulling the thigh strap laterally under the patient’s thigh. This will seat the lower end of the cushion comfortably against the ischial tuberosity. Tighten the thigh strap lightly. Lift the spring clip to extend the inner shaft on the SX404 until the crossbar rests adjacent to the patient’s heels.