Traction table versus manual traction in the intramedullary nailing of unstable intertrochanteric fractures: A prospective randomized trial

Injury. 2016 Jul;47(7):1547-54. doi: 10.1016/j.injury.2016.04.012. Epub 2016 Apr 20.


Introduction: The purpose of this prospective randomized study was to compare traction table with manual traction for the reduction and nailing of unstable intertrochanteric femur fractures.

Design: Prospective, randomized, two-center trial.

Materials and methods: 72 elderly patients with AO/OTA 31A2 and 31A3 proximal femur fractures were randomized to undergo surgery with either manual traction (MT) or traction table (TT) facilitated intramedullary nailing. The demographics and fracture characteristics, duration of preparation and surgery, total anaesthesia time, fluoroscopy time, blood loss, number of assistants, early post-operative radiological evaluations and 6th month functional and radiological outcomes were evaluated. Data of 64 patients attending 6th month follow-up examination were evaluated statistically.

Results: No significant differences were observed between groups regarding demographics and fracture characteristics. In the manual traction group, there was a significant time gain in respect of the positioning and preparation period (18.0±1.6min in MT group, 29.0±2.4min in TT group) (p<0.05). In terms of total anaesthesia time (Preparation+surgery) approximately 6min of difference was observed in favor of MT group (72.8±14.0min for MT and 78.6±6.5min for TT, [p<0.05]). Median number of assistants needed was significantly lower in TT group (2 assistants [1-3]) in MT group and (1 assistant [1,2]) in TT group [p<0.05]). There was no significant difference between two groups regarding other surgical and outcome parameters.

Conclusions: Manual traction reduced the preparation time and total anaesthesia duration, despite an increase in number of surgical assistant.

Level of evidence: Level II.

Keywords: Intertrochanteric fracture; Intramedullary nailing; Surgery; Traction.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Intramedullary* / instrumentation
  • Fracture Fixation, Intramedullary* / methods
  • Hip Fractures / epidemiology
  • Hip Fractures / surgery*
  • Humans
  • Male
  • Operating Tables*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Postoperative Complications / surgery*
  • Prospective Studies
  • Supine Position
  • Traction / instrumentation*
  • Traction / methods
  • Treatment Outcome
  • Turkey / epidemiology