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

Area of Science:

• Orthopedic surgery
• Trauma care
• Pain management

Background:

• Pre-operative traction is used for femoral fractures, but its effectiveness for pain relief is debated.
• Current guidelines for pre-operative traction in femoral fractures are not clearly established.

Purpose of the Study:

• To assess the pain relief efficacy of different pre-operative traction systems in proximal and femoral shaft fractures.
• To compare skeletal traction versus skin traction for pain relief.
• To compare pre-operative traction versus no traction for pain relief.

Main Methods:

• A meta-analysis was conducted, searching PubMed, Cochrane, Embase, and Google Scholar until January 2024.
• Included studies focused on clinical outcomes, specifically pain scales following traction.
• Data from randomized clinical trials and one prospective study were analyzed.

Main Results:

• No significant difference in post-operative Visual Analog Scale (VAS) pain scores was found between skeletal and skin traction.
• No significant difference in post-operative VAS pain scores was observed between groups receiving traction and those not receiving traction.
• The analysis included data from 10 randomized clinical trials and one prospective study, involving a total of 1001 patients.

Conclusions:

• Pre-operative traction offers no added benefit for pain relief in femoral fractures.
• Systematic pre-operative traction should not be universally applied to all femoral fractures due to potential complications and lack of demonstrated pain relief advantage.