Preoperative Skeletal Versus Cutaneous Traction for Femoral Shaft Fractures Treated Within 24 Hours

Even, Jesse L.; Richards, Justin E.; Crosby, Colin G.; Kregor, Philip J.; Mitchell, Erika J.; Jahangir, A. Alex; Tressler, Marc A.; Obremskey, William T.

doi:10.1097/bot.0b013e31823a8dae

Cited by 25 publications

(17 citation statements)

References 6 publications

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“…In the next study, more patients should be attended. In addition, there could be some other studies contrasting the effect of both skin and bone traction ( 28 - 30 ), while we have not measured the bone traction. We recommend taking this matter into account by the researchers.…”

Section: Discussionmentioning

confidence: 92%

“…This matter is especially important in young patients because despite hip fracture is very rare among the youth, as it results from traumas with high energy, it is accompanied by more severe pain ( 24 ). Studies have been conducted on the role of skin traction in the pain of these patients ( 23 - 28 ), but the present results are vague as well as contradictory and require more randomized studies. In addition, regardless of all related studies, this method is being used in trauma centers.…”

Section: Introductionmentioning

confidence: 81%

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The Effect of Skin Traction on Preoperative Pain and Need for Analgesics in Patients With Intertrochanteric Fractures: a Randomized Clinical Trial

et al. 2015

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Background:Preoperative skin traction is applied for many patients with hip fracture. However, the efficacy of this modality in pain relief is controversial.Objectives:The aim of the current study was to investigate the effects of skin traction on pain in patients with intertrochanteric fractures.Patients and Methods:A total of 40 patients contributed in this randomized clinical trial. Patients were randomly allocated into two equal groups: the skin traction (3 kg) and control groups. The severity of pain was recorded at admission and 30 minutes, one, six, 12, and 24 hours after skin traction application utilizing a Visual Analogue Scale (VAS). In addition, the number of requests for analgesics was recorded. Finally, the mean severity of pain in each measurement and the mean number of analgesic requests were compared between the two groups.Results:The severity of pain was significantly decreased in skin traction group only at the end of the first day after traction application (2.7 ± 0.8 vs. 3.3 ± 0.9; P = 0.042), while there was no significant difference between the two groups in other pain measurements. The number of requests for analgesics was the same between the two groups.Conclusions:Although skin traction had no effect on analgesic consumption, it significantly decreased the pain at the end of the first day. The application of skin traction in patients with intertrochanteric fractures is recommended.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 81%

The Effect of Skin Traction on Preoperative Pain and Need for Analgesics in Patients With Intertrochanteric Fractures: a Randomized Clinical Trial

et al. 2015

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“…Extramedullary skeletal clamps have been shown to have inferior pullout strength to a tensioned trans-femoral Kirschner wire and do not eliminate the risk of pin infection (10). Four prospective studies have compared skeletal and skin traction for femur fractures, although three of these included only hip fractures (5, 11–13). Even et al recently compared skin and distal femoral skeletal traction for diaphyseal femoral fractures in a prospective randomized trial (5).…”

Section: Discussionmentioning

confidence: 99%

“…Four prospective studies have compared skeletal and skin traction for femur fractures, although three of these included only hip fractures (5, 11–13). Even et al recently compared skin and distal femoral skeletal traction for diaphyseal femoral fractures in a prospective randomized trial (5). They found no significant differences in post-traction pain relief, pain medication requirements, or intra-operative fracture reduction time between the two methods.…”

Section: Discussionmentioning

confidence: 99%

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A Prospective Study of Pain Reduction and Knee Dysfunction Comparing Femoral Skeletal Traction and Splinting in Adult Trauma Patients

Bumpass

Ricci

McAndrew

et al. 2015

Journal of Orthopaedic Trauma

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Objectives 1) Determine if distal femoral traction pins result in knee dysfunction in femoral or pelvic fracture patients, and 2) to determine if skeletal traction relieves pain more effectively than splinting for femoral shaft fractures. Design Prospective cohort trial. Setting Level I urban trauma center. Patients/Participants 120 adult patients with femoral shaft, acetabular, and unstable pelvic fractures. Intervention Patients with femoral shaft fractures were placed into distal femoral skeletal traction or a long-leg splint, based on an attending-specific protocol. Pelvic or acetabular fracture patients with instability or intra-articular bone fragments were placed into skeletal traction. Main Outcome Measurements An initial Lysholm knee survey was administered to assess pre-injury knee pain and function; the survey was repeated at 3- and 6-month follow-up visits. Also, a 10-point visual analog scale (VAS) was used to document pain immediately before, during, and immediately after fracture immobilization with traction or splinting. Results Thirty-five patients (29%) were immobilized with a long-leg splint, and 85 (71%) were immobilized with a distal femoral traction pin. Eighty-four patients (70%) completed 6-month follow-up. Lysholm scores decreased by a mean 9.3 points from pre-injury baseline to 6 months post-injury in the entire cohort (p<0.01); no significant differences were found between the splint and traction pin groups. During application of the immobilization, VAS pain scores were significantly lower in traction patients as compared to splinted patients (mean 1.9 points less, p<0.01). Traction pins caused no infections, neurovascular injuries, or iatrogenic fractures. Conclusions Distal femoral skeletal traction does not result in detectable knee dysfunction at six months post-insertion, and results in less pain during and after immobilization than long-leg splinting.

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Rehabilitation, Physiotherapy and Prosthetics

Gohy¹

2016

Orthopaedic Trauma in the Austere Environment

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Preoperative Skeletal Versus Cutaneous Traction for Femoral Shaft Fractures Treated Within 24 Hours

Cited by 25 publications

References 6 publications

The Effect of Skin Traction on Preoperative Pain and Need for Analgesics in Patients With Intertrochanteric Fractures: a Randomized Clinical Trial

The Effect of Skin Traction on Preoperative Pain and Need for Analgesics in Patients With Intertrochanteric Fractures: a Randomized Clinical Trial

A Prospective Study of Pain Reduction and Knee Dysfunction Comparing Femoral Skeletal Traction and Splinting in Adult Trauma Patients

Rehabilitation, Physiotherapy and Prosthetics

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