Comparative study between lateral decubitus and traction table for treatment of pertrochanteric fractures with cephalomedullary nails

Abstract

ObjectiveTo perform a retrospective radiographic assessment of the reduction and implant position in the femoral head in patients with pertrochanteric fractures treated with cephalomedullary nailing in the lateral position versus traction table.MethodsRadiographs of patients with pertrochanteric fracture of the femur treated with cephalomedullary nailing in the lateral position and traction table were retrospectively evaluated. For the evaluation we used the anteroposterior radiographic view of the pelvis and the lateral view of the affected side. The cervicodiaphyseal angle, the tip-apex distance (TAD), and the spatial position of the cephalic component in the head were measured. Two patient groups were created, one group operated on the traction table and another group operated in the lateral position.ResultsRegarding the cervicodiaphyseal angle observed in the traction table group, the results of 11 patients (61.1%) were outside the acceptable parameters proposed in the present study. Both groups were equivalent regarding TAD and the position of the cephalic component in the head.ConclusionA difference in the cervicodiaphyseal angle was observed; the group operated on the traction table had 11 patients (61.1%) whose measurements were outside the acceptable parameters.

Whether Assisted Intramedullary Nail Implantation Without Traction Table is as Safe and Effective as Using Traction Table of Older Intertrochanteric Fracture Patients?

“…Of these eight studies, four studies comparing the radiographic and clinical outcomes of traction table versus lateral decubitus in the treatment of intertrochanteric fractures. [21][22][23][24] Three studies compared the clinical outcomes of intertrochanteric fractures treated with traction repositors (without a traction table) with those treated using a traction table. [25][26][27] One study compared the final outcomes of a traction table versus manual traction for the treatment of unstable intertrochanteric fractures.…”

“…For the patients in the traction table group, the adjustment of the reduction was completed during the setup time at the beginning of the operation, and it was difficult to finely adjust the reduction during the operation, as the fine adjustment is made with a nonsterile device. 21 All of the studies we included found no difference between the two groups in reduction quality, and the good and acceptable rates of the two groups were basically the same (the traction table group was 95.1% and the non-traction table group was 95.3%). Tip-apex distance (TAD) and cervicodiaphyseal angle (CDA) are widely accepted parameters used to evaluate whether the reduction and positioning of the cephalic element in both positioning methods were equivalent.…”