Note the absence or presence of distal pulses, check for sensation. Position the malleolar harness (ankle harness) beneath the heel(s) and just above the ankle(s). Fold down the number of comfort cushions needed to engage the ankle above the medial and lateral malleoli. Using the attached hook and loop straps wrap the ankle harness around the ankle to secure snugly. Pull control tabs to engage the ankle harness tightly against the crossbar. Apply Quantifiable Dynamic Traction™. Grasp the padded shaft of the SX404 with one hand and the red traction handle with the other; gently extend the inner shaft until the desired amount of traction is recorded on the traction scale. It is suggested to use 10% of the patient’s body weight per fractured femur up to 7kg (15 pounds) for each leg. If bilateral fractures are present – the maximum amount would be 14kg (30 pounds). At the hollow of the knees, gently slide the large tensor cravat through and sizzer it upwards to the thigh, repeating with the smaller cravats to minimize lower and mid-limb movement.