Dr Hao Wei
Yantai Yuhuangding Hospital
Prospective cohort study has been implemented concerning therapeutic effect through traction achieved using an intraoperative femoral fracture reduction device(IFFRD) with that observed using a traction table for closed reduction of trochanteric fractures via intramedullary nail fixation.
Herein, 141 eligible patients (OTA type 31-A1, n=28; A2, n=75; and A3, n=38 cases) were randomized to the IFFRD (n=73) or traction table (n=68) group. The IFFRD was used while the patient was placed on a normal radiolucent operation table with 25-30 elevation of the injured side to allow for antero-posterior and lateral fluoroscopic examination and facilitate entry-point guide wire insertion.
Patient demographics, operative and fluoroscopy duration, blood loss, number of surgical assistants required, quality of fracture reduction, radiological bone union time, postoperative motility, and residence status were recorded.
Patient demographics were similar between groups. Duration of patient positioning was longer in the traction table group (p<0.05); however, durations of fluoroscopy, fracture reduction, and fixation were comparable. Blood loss was greater in the traction table group(p<0.05). Unscrubbed assistants were not required throughout the procedure when the IFFRD was used (p<0.05). Postoperative bone union time, ambulatory status, residence, and Harris score were similar between the groups (p>0.05).
An IFFRD used with a normal radiolucent operation table decreased patient positioning time, blood loss, and need for unscrubbed assistants, with efficacy comparable to the traction table approach for closed reduction of trochanteric fractures.
Level of Evidence: Level II, Prospective cohort study