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

Document Type : SYSTEMATIC REVIEW

Authors

1 Hotel Dieu de France, Orthopedics department, Beirut, Lebanon

2 Division of Orthopaedic Surgery, Brown University, Providence, RI, USA

3 Division of Orthopaedic Surgery and Sports Medicine, McGill University Health Centre, Montreal, Quebec, Canada

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.
 Level of evidence: IV

Keywords

Main Subjects


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