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

Abstract

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.

A comparative evaluation of the efficacy between skeletal traction and skin traction in pre-operative management of femur shaft fractures in Korle Bu Teaching Hospital

“…This finding is consistent with a study done by Alireza Manafi Rasi et al, that concluded that traction does not interfere with the need for analgesics, but it remarkably decreases the pain in patients with proximal femur fractures and it assists the patient's comfort and relaxation. 13 The application of skin traction before the surgery in these patients is recommended.…”

“…This finding is in accordance with the study done by Gosselin RA, Heitto M, Zirkle L. and Musajee M that concluded that although simple, the insertion and care of these pins can be accompanied by severe complications including damage to neurovascular structures, ligamentous insult, fracture, and infection. 9 , 13 …”

“…Distal femoral skeletal traction remains a commonly used method for pre-operative fracture stabilization and pain control in patients with femoral shaft, neck, acetabular, and unstable pelvic fractures 13 . The purpose of this study was to compare the outcomes (pain, limb length discrepancy, intraoperative blood loss and complications) of preoperative Skeletal and Skin traction in adult femoral shaft fractures awaiting surgical fixation within 2 weeks of presentation in Korle Bu Teaching Hospital.…”

The Role of Preoperative Skin Traction in Reducing Pain in Patient with Hip Fracture

“…They are common in female patient with ratio 3:1. Risk factors include, osteoporosis 1 impaired neurology, malnutrition, impaired vision, tumor and physical inactivity. 2 Sub trochanteric fractures, also included in proximal femur fracture with by model distribution pattern that is common in patients with 20 to 40 years of age and then in patients with more than 60 years of age.…”

“…Scoring ranges from 0 to 10, where 0 will be taken as no pain and 10 for severe pain. 5 In a study done by Saygi et 1,6 al pain reduction among patients with intertrochanteric femur fracture with skin traction and without skin traction was compared. The pain assessed on visual analogue scoring (VAS) at 12 hours preoperatively and score was found 3.63 (± 0.84) and 3.04 (± 0.76) respectively.…”