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Review
. 2024;12(10):683-689.
doi: 10.22038/ABJS.2024.78869.3622.

Pre-Operative Traction in Femoral Fractures for Pain Management: A Meta-Analysis of Comparative Studies

Jean Tarchichi, Mohammad Daher, Ali Ghoul, Michel Estephan, Jad Mansour
Review

Pre-Operative Traction in Femoral Fractures for Pain Management: A Meta-Analysis of Comparative Studies

Jean Tarchichi et al. Arch Bone Jt Surg. 2024.

Abstract

Objectives: This meta-analysis studies and assesses the pain relief effect of different pre-operative traction systems in proximal and femoral shaft fractures as this subject is still debated and no clear guidelines are established.

Methods: PubMed, Cochrane, Embase and Google Scholar (page 1-20) were searched until January 2024. The clinical outcomes collected consisted of pain scales following traction.

Results: Two randomized clinical trials were included to compare skeletal (72 patients) to skin traction (80 patients) and eight randomized clinical trials with one prospective study were included to compare traction (457 patients) versus no traction (439 patients). Our results revealed no differences in terms of post-operative pain VAS between both the skeletal and skin traction as well as between traction and no traction.

Conclusion: No added benefit of traction was observed when pain relief is the main consideration. Furthermore, with their different potential complications, systematic pre-operative traction should not be implemented in all femoral fractures.

Keywords: Femoral shaft fracture; Hip fracture; Intertrochanteric fracture; Skeletal traction; Skin traction.

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Conflict of interest statement

The author(s) do NOT have any potential conflicts of interest for this manuscript.

Figures

Figure 1
Figure 1
PRISMA flowchart for article selection process
Figure 2
Figure 2
(A): Risk of bias item for each included study. (B) Risk of bias item presented as percentages across all included studies
Figure 3
Figure 3
Forest plot showing the pain after traction in skin traction and skeletal traction
Figure 4
Figure 4
Forest plot showing the pain after traction in the traction group and group without traction
See this image and copyright information in PMC

References

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