Efficacy of preoperative skin traction for hip fractures: a single-institution prospective randomized controlled trial of skin traction versus no traction

Balanced Suspension versus Pillow on Preoperative Pain for Proximal Femur Fractures: A Randomized Controlled Trial

“…Proximal femur fractures are painful and can cause complications while the patient is waiting for definitive surgery. There are many interventions to either immobilize or adjust a limb, so as to reduce pain in patients with skeletal fractures, for example, skin traction and a pillow, but none of them show superiority to the others [ 5 – 7 ]. Balanced suspension is an intervention that can reduce the gravitational load on the extremity.…”

“…ere are many options for preoperative intervention for patients with proximal femur fractures, such as skin traction, skeletal traction, or simple placement of a pillow under the injured limb [5][6][7][8][9][10]. However, none of these techniques have shown to have any superior effect of pain relief among other techniques [6].…”

Clinical practice and nursing management of pre-operative skin or skeletal traction for hip fractures in elderly patients: a cross-sectional three-institution study

“…The two main methods of traction are skin and skeletal. During routine practice, in Italian Emergency Departments, as well as in those of other southern European nations (Endo et al, 2013;Saygi et al, 2010;Irajpour et al, 2012;Tosun et al, 2018), the first is used mostly for proximal femur fractures also known as "hip fracture", in particular for intracapsular involvement, while the second is applied mainly for femoral diaphyseal fractures and in some cases also for displaced extracapsular hip fractures, like subtrochanteric. For skin or skeletal traction, the limb is connected to a rope linked to a variable weight, which exerts the pulling force (Flynn, 2018;Santy-Tomlinson, 2017).…”

“…According to Benzinger et al (2016), this will continue to increase by more than 20% by 2025. This is a direct consequence of increased life expectancy and progressive aging of the population (Endo et al, 2013). Hip fractures cause a significant socio-economic burden (Guy et al, 2017;Rapp et al, 2010;Kanis et al, 2012;Saletti-Cuesta et al, 2017), with an average 10% mortality within 30 days and more than 30% within one year (National Clinical Guideline Centre, 2011).…”

“…To prevent complications, promote comfort, reduce pain and ease fracture reduction, the affected hip joint must be maintained in a stable position that assists nurses to provide better care during bed mobilisation for hygiene care. Traditionally the use of traction for intracapsular fractures was thought to reduce pain (Endo et al, 2013), although nowadays this is debated (Tosun et al, 2018). Skin or skeletal traction is still used during the preoperative period in many countries, including Italy, remaining a standard practice in some hospitals (Saygi et al, 2010;Matullo et al, 2016).…”