When treating a patient with an angulated fracture and no distal pulse, what is the appropriate step to take?

In the scenario of a patient with an angulated fracture and no distal pulse, the appropriate action is to apply gentle traction until a pulse is palpable. This approach is critical because the absence of a pulse suggests that there may be a compromise in blood flow to the limb, often due to displacement of bone fragments or swelling causing compression of blood vessels.

Applying gentle traction can help realign the fractured bone, potentially alleviating any pressure on the surrounding vascular structures. This maneuver aims to restore circulation to the distal extremity, which is vital for maintaining limb viability and preventing further complications from ischaemia.

While other interventions, such as applying a traction splint or wrapping the limb in a trauma dressing, are important options in managing fractures, they do not address the immediate need to re-establish circulation as effectively as gentle traction does in this specific situation. It is important to first attempt to restore blood flow before considering immobilization or transport.