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

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 ۱-۲۰) were searched until January ۲۰۲۴. The clinical outcomes collected consisted of pain scales following traction.Results: Two randomized clinical trials were included to compare skeletal (۷۲ patients) to skin traction (۸۰ patients) and eight randomized clinical trials with one prospective study were included to compare traction (۴۵۷ patients) versus no traction (۴۳۹ 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:

Femoral shaft fracture , Hip fracture , intertrochanteric fracture , Skeletal traction , Skin traction