The application of lower extremity skeletal traction is a skill that orthopaedic surgeons use for fracture stabilization before surgical fixation. Historically, lower extremity skeletal traction also has been used to maintain the alignment and stability of fractures during nonsurgical management. Common indications for the application of traction pins include fracture realignment and immobilization; minimization of muscle spasm; and prevention of muscle contractures, which may make surgical fixation difficult. Complications associated with lower extremity skeletal traction include physeal damage in pediatric patients, infection, and neurovascular injury. This video demonstrates the proper technique for applying tibial skeletal traction.