Audio Distraction for Traction Pin Insertion: A Prospective Randomized Controlled Study

Area of Science:

• Orthopedic Surgery
• Pain Management
• Patient Experience

Background:

• Skeletal traction pin insertion in the distal femur or proximal tibia is often painful and distressing for patients with lower-extremity fractures.
• Assessing patient-reported and physician-reported outcomes is crucial for evaluating procedural interventions.

Purpose of the Study:

• To determine if audio distraction (AD) during skeletal traction pin insertion can improve patient experience and reduce pain and anxiety.
• To evaluate the impact of AD on physician-reported procedural difficulty.

Main Methods:

• Prospective randomized controlled trial conducted at two level-I trauma centers.
• Inclusion criteria: Patients ≥18 years old, conscious, oriented, and requiring skeletal traction.
• Patients were randomized to receive audio distraction (AD) or no AD during pin insertion; outcomes were assessed via patient and physician surveys using a 1-to-10 Likert scale.

Main Results:

• A total of 54 patients were included; 28 received AD and 26 did not.
• No significant differences were observed in overall patient-reported experience (p=0.55) or pain levels (p=0.28) between the groups.
• A statistically significant reduction in anxiety levels was noted in the AD group compared to the no-AD group (p=0.007); physician-reported difficulty was similar (p=0.69).

Conclusions:

• Audio distraction (AD) is a feasible and low-cost intervention for reducing patient anxiety during lower-extremity skeletal traction pin insertion.
• AD may enhance the patient's procedural experience without negatively impacting pain or physician-assessed difficulty.