Zhigang Wang1, Wei Hao2, Dong Liu1, Kai Zhang1, Long Jia1, Shuye Yang1, Zhaolin Wang1, Degang Zhang1, Dechun Zhang1. 1. Department of Orthopaedics and Traumatology, Affiliated Hospital of Binzhou Medical University, Binzhou, Shandong Province, China. 2. Department of Orthopaedics and Traumatology, Yantai YuHuangDing Hospital Affiliated to Qingdao University Medical College, Yantai, Shandong Province, China.
Abstract
OBJECTIVE: Traction achieved using an intraoperative femoral fracture reduction device (IFFRD) was compared with that observed using a traction table (TT) for closed reduction of trochanteric fractures and cephalomedullary nail fixation. DESIGN: Prospective cohort study. SETTING: Level 1 trauma center. PATIENTS: One hundred forty-one eligible patients with 141 fractures (Orthopaedic Trauma Association type 31-A1, n = 28; A2, n = 75; and A3, n = 38 cases) were randomized to the IFFRD (n = 73) or TT (n = 68) group. INTERVENTION: The IFFRD was used while the patient was placed on a normal radiolucent operation table with 25-30 degrees elevation of the injured side to allow for antero-posterior and lateral fluoroscopic examination and facilitate entry-point guide wire insertion. MAIN OUTCOME MEASURES: Patient demographics, operative and fluoroscopy duration, quality of fracture reduction, and radiological bone union time were recorded. RESULTS: Patient demographics were similar between groups. Duration of patient positioning was longer in the TT group (P < 0.05); duration of fluoroscopy, fracture reduction, and time to union were comparable. CONCLUSIONS: An IFFRD used with a normal radiolucent operation table decreased patient positioning time, with efficacy comparable to the TT approach for closed reduction of trochanteric fractures. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
RCT Entities:
OBJECTIVE: Traction achieved using an intraoperative femoral fracture reduction device (IFFRD) was compared with that observed using a traction table (TT) for closed reduction of trochanteric fractures and cephalomedullary nail fixation. DESIGN: Prospective cohort study. SETTING: Level 1 trauma center. PATIENTS: One hundred forty-one eligible patients with 141 fractures (Orthopaedic Trauma Association type 31-A1, n = 28; A2, n = 75; and A3, n = 38 cases) were randomized to the IFFRD (n = 73) or TT (n = 68) group. INTERVENTION: The IFFRD was used while the patient was placed on a normal radiolucent operation table with 25-30 degrees elevation of the injured side to allow for antero-posterior and lateral fluoroscopic examination and facilitate entry-point guide wire insertion. MAIN OUTCOME MEASURES: Patient demographics, operative and fluoroscopy duration, quality of fracture reduction, and radiological bone union time were recorded. RESULTS:Patient demographics were similar between groups. Duration of patient positioning was longer in the TT group (P < 0.05); duration of fluoroscopy, fracture reduction, and time to union were comparable. CONCLUSIONS: An IFFRD used with a normal radiolucent operation table decreased patient positioning time, with efficacy comparable to the TT approach for closed reduction of trochanteric fractures. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Authors: Max P L van der Sijp; Marianne de Groot; Sven A Meylaerts; Karel J du Pré; Sander M Verhage; Inger B Schipper; Arthur H P Niggebrugge Journal: Arch Orthop Trauma Surg Date: 2021-02-26 Impact factor: 2.928