Journal of Musculoskeletal Trauma

Original Articles

A Skeletal Traction on the Radiolucent Table in Closed Intramedullary nailing of Femoral Fracture: Eun Woo Lee, Han Jun Lee, Kee Hyun Lee, Ho Sun Jin; J Korean Fract Soc 2005;18(3):244-249. Published online July 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.3.244

Abstract PDF: PURPOSE
To evaluate the clinical results of femoral shaft fracture treated by Intramedullary (IM) nailing through skeletal traction compared with manual traction on a radiolucent table.
MATERIALS AND METHODS
Thirty cases with femoral shaft fracture treated with closed IM nailing from January 2000 to June 2002 were divided into two groups; fifteen fractures reduced by manual traction (Group A) and fifteen fractures reduced by skeletal traction (Group B) on a radiolucent table. The number of people participated in the operations, operation and radiation exposure time, and post-operative complications were evaluated.
RESULTS
The number of people participated in the operations was five in Group A and four in Group B. The average operation time was 116 minutes and 82 minutes (p<0.001). The radiation exposure time was 2.8 minutes and 1.2 minutes (p<0.001). However, there was no significant difference in the post-operative complications such as shortening or lengthening of bone between two groups.
CONCLUSION
There was no significant difference in the operative outcome between two groups. However, skeletal traction has positive effects of reducing the operation time, radiation exposure time, and number of people participating in the operations. Also, regarding the consistent traction power, skeletal traction is the better treatment modality in maintaining the alignment and length of femoral bone than manual traction.

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The Incidence of Infection in Interlocking Intramedullary Nailing after Skeletal Traction of Distal Femur: Hyuk Woo Nam, Seung Woo Suh, Hae Reong Song, Jun Gyu Moon, Jun Ho Wang, Chan Eung Park, Jae Hyuk Yang; J Korean Fract Soc 2005;18(1):12-16. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.12

PURPOSE
The insertion site of K-wire for skeletal traction is proximal part of tibia or distal part of femur. However, people prefer proximal tibia over distal femur due to lower risk of infection rate when change to interlocking IM nailing is needed. We evaluated the infection rate of interlocking IM nailing.
MATERIALS AND METHODS
Fourty-seven patients were included in this study who underwent interlocking IM nailing due to femur shaft fracture. Traction was applied at the distal femur in 19 cases and proximal tibia in 10 cases before interlocking IM nailing. No skeletal traction was applied to the remaining 18 cases. Thirty-eight patients were male and 9 were female. The average age at the time of surgery was 36.7 years old (range, 15~17 years). The average traction period was 9.5 days (range, 3~33 days) and the average followed-up period was 17.2 months.
RESULTS
In the distal femoral traction group, 8 cases of superficial pin tract infection developed, but no case of deep infection such as osteomyelitis occurred. In the proximal tibia traction group, 2 cases of superficial pin tract infection developed, but no case of deep infection occurred. In the group that received no skeletal traction before interlocking IM nailing, no case of infection developed.
CONCLUSION
In femur shaft fracture, the distal femoral skeletal traction followed by interlocking IM nailing of femur, compared to proximal tibia skeletal traction, did not increase the risk of deep infection such as osteomyelitis.

Citations

Citations to this article as recorded by

Rectus femoris muscle atrophy and recovery caused by preoperative pretibial traction in femoral shaft fractures-comparison between traction period
D.-G. Shim, T.-Y. Kwon, K.-B. Lee
Orthopaedics & Traumatology: Surgery & Research.2017; 103(5): 691. CrossRef

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The Comparative Sturdy of Treatment between the Skeletal Traction and the Operation of the Supracondylar Fracture in Children: Eu Sub Chung, Young Kee Lee, Byoung Ho Lee; J Korean Soc Fract 1998;11(4):970-976. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.970

Abstract PDF: The most common fracture about the elbow joint in children is supracondylar fracture. That treatment has many fitsfalls and had writtened about its method and the prevention of serious complication such as Volkmann ischemic contractre and cubitus varus deformity. the authors analyzed the follow-up results of 58 cases of supracondylar fractures treated by skeletal traction, percutaneous pinning and open reductionin Persbyterian Medical Center from March 1992 to November 1996. The average follow-up was 20 months(12-54 months). The results were as follows. 1. The mean age was 7.8 years, ranged from 1 year to 15 years, and the male and the female ratio was 1.9:1. 2. Seventeen cases were treated with skeletal traction group, thirty cases with closed reduction and percutaneous pinning group, eleven cases with open reduction and internal fixation group. 3. The average duration of admission in skeletal traction group was 23.5 days, 5.2 days in percutaneous pinning group and 14.7 days in open reduction and internal fixation group. 4. The ration of hospital cost to that in the skeletal group were 0.85+/-0.18 in the percutneous pinning group, and 1.43+/-0.21 in the open reduction and internal fixation group. 5. According to the Mitchell and Adams' criteria, the results of skeletal tracion group were excellent in 58.8%, good in 35.3% and poor in 5.9%; the results of percutaneous pinning group were excellent in 60%, good in 36.7% and poor in 3.3% ; and those of open reduction group were excellent in 54.5%, good in 27.3% and poor in 18.2%, respectively, on mean follow-up of 1 year and 8 month. So, our result indicated that the closed reducion and percutaneous pinning is a simple and cost-effective method for treatment of supracondylar fractures of the humerus in children, but some instances, the skeletal traction might be another treatment method in supracondylar fractures.

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