Skeletal Traction for Isolated Femur Fractures Does Not Reduce Opioid Consumption

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Pain Management

Background:

• Isolated femoral shaft fractures require preoperative management.
• Treatment options include skeletal traction (TXN) and position of comfort (COMF).
• Opioid consumption is a key concern in fracture management.

Purpose of the Study:

• To compare preoperative opioid consumption between TXN and COMF for isolated femoral shaft fractures.
• To evaluate the impact of different preoperative treatments on opioid use.

Main Methods:

• Retrospective case-control study at two Level 1 trauma centers.
• Included 220 patients with isolated OTA/AO 32A-C femoral shaft fractures (2017-2020).
• Primary outcome: preoperative opioid consumption (morphine milligram equivalents).

Main Results:

• Skeletal traction group consumed significantly more opioids in the emergency department (2.6 MME more, P=0.031).
• No significant difference in opioid consumption was found on the hospital floor or for the entire preoperative course.
• Total preoperative opioid consumption rate (MME/hour) did not differ between groups.

Conclusions:

• Skeletal traction leads to higher initial opioid use in the emergency department for femoral shaft fractures.
• Position of comfort is a viable alternative to skeletal traction, with similar overall preoperative opioid consumption.
• Consideration of COMF may help optimize pain management strategies in trauma care.