Is proximal femoral nailing of unstable intertrochanteric fractures in the lateral decubitus position without a traction table as safe and effective as on a traction table?

Doğan, Necati; Ertürk, Cemil; Gülabi, Deniz

doi:10.1016/j.injury.2021.11.017

Cited by 14 publications

(22 citation statements)

References 21 publications

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“…The number of the elderly with proximal femoral fractures has gradually increased. Looking for effective and low side effects of treatment is a hot topic for scholars [ 17 – 20 ]. Therefore, 104 patients with proximal femoral fractures treated with proximal femoral nail antirotation were divided into 52 cases of the experimental group (ultrasound-guided lumbar plexus-sacral plexus block based on image segmentation algorithm + dexmedetomidine) and 52 cases of routine group (endotracheal intubation and inhalation combined with general anesthesia), and the image segmentation algorithm based on local fitting was constructed to enhance the ultrasound image.…”

Section: Discussionmentioning

confidence: 99%

Effect of Low-Dose Dexmedetomidine Combined with Lumbosacral Plexus Block Guided by Ultrasound Imaging Based on Image Segmentation Algorithm in Fracture Surgery

Wang

He³

et al. 2022

Computational Intelligence and Neuroscience

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The aim of this study was to analyze the application of ultrasound-guided low-dose dexmedetomidine combined with lumbosacral plexus block based on artificial intelligence algorithm in the surgical treatment of proximal femoral fractures. 104 patients with proximal femoral fractures were divided into 52 cases in the experimental group (ultrasound-guided lumbosacral plexus block combined with dexmedetomidine based on local fitting image segmentation algorithm) and 52 cases in the routine group (endotracheal intubation and inhalation combined with general anesthesia). An image segmentation algorithm based on local fitting was constructed to enhance the ultrasound image. It was found that in the routine group, the heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) at the beginning of intravenous injection of dexmedetomidine, during skin incision, and half an hour after skin incision were significantly lower than those at admission ( P < 0.05 ). The pressing times of patient-controlled intravenous analgesia (PCIA) in the conventional group (17.05 ± 6.85 times) were significantly higher than that in the experimental group (8.55 ± 4.12 times), and the difference was statistically significant ( P < 0.05 ). The visual analogue scale (VAS) scores at 1, 5, 10, and 15 after operation in the routine group were significantly higher than those in the experimental group ( P < 0.05 ). The number of dizziness, nausea, and vomiting, venous thrombosis of lower limbs, cardiovascular events, and pulmonary infection in the routine group on the 1st, 2nd, and 3rd days after operation were significantly higher than those in the experimental group ( P < 0.05 ). In summary, the ultrasound-guided lumbar plexus-sacral plexus block combined with dexmedetomidine anesthesia based on image segmentation algorithm can effectively maintain the hemodynamic stability of patients, with remarkable analgesic effect and high safety.

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Section: Discussionmentioning

confidence: 99%

Effect of Low-Dose Dexmedetomidine Combined with Lumbosacral Plexus Block Guided by Ultrasound Imaging Based on Image Segmentation Algorithm in Fracture Surgery

Wang

He³

et al. 2022

Computational Intelligence and Neuroscience

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Li¹,

Chungui²,

Zhang³

2023

CIA

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Despite promising clinical outcome proposals, there has been relatively little published regarding the use of traction tableassisted intramedullary nail implantation for intertrochanteric fractures. The purpose of this study is to further summarize and evaluate published clinical studies comparing the clinical outcomes of using traction table and without traction table in the management of intertrochanteric fracture. Methods: A comprehensive literature search using PubMed, Cochrane Library, and Embase was systematically performed to evaluate all studies included in the literature up to May 2022. The search terms included "intertrochanteric fractures", "hip fractures", and "traction table" with Boolean operators "AND" and "OR". The following information was extracted and summarized: demographic information, setup time, surgical time, amount of bleeding, fluoroscopy exposure time, reduction quality, and Harris Hip Score (HHS). Results: A total of eight clinical controlled studies involving 620 patients were eligible for the review. The mean age at the time of injury was 75.3 years (traction table group 75.7 years, non-traction table group 74.9 years). The most common assisted intramedullary nail implantation method of non-traction table group included lateral decubitus position (4 studies), traction repositor, (3 studies) and manual traction (1 studies). Included studies results all support that there was no difference between the two groups in terms of reduction quality and Harris Hip Score, and the non-traction table group had an advantage in terms of setup time. However, there were still disputes in terms of surgical time, amount of bleeding and fluoroscopy exposure time. Conclusion:For patients with intertrochanteric fractures, assisting intramedullary nail implantation without traction table is as safe and effective as using traction table and doing so without a traction table may be more advantageous in terms of setup time.

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“…However, the number of related studies is insufficient, and this conclusion should be treated cautiously. Using a traction repositor will cause additional damage to the patient, which should also be considered carefully [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Is the traction table necessary to treat femoral fractures with intramedullary nailing? A meta-analysis

Wang

2023

J Orthop Surg Res

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Background The traction table is generally used in femoral intramedullary nailing surgery. Recently, some published studies have shown that the same or better treatment effects can be gotten without a traction table. It remains no consensus on this issue. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was applied in this study. We searched PubMed, Embase, Web of Science, and Cochrane Library databases for eligible studies. The random-effect model was used to calculate the standardized mean difference (SMD) and risk ratios with 95% CIs. Trial sequential analysis (TSA) was performed to verify the results. Results The pooled estimates of seven studies, including 266 cases each in the manual traction group and traction table group, indicated that manual traction could shorten operative time [SMD, − 0.77; 95% CI (− 0.98, − 0.55); P < 0.00001] and preoperative set-up time [SMD, − 2.37; 95% CI (− 3.90, − 0.84); P = 0.002], but it would not reduce intraoperative blood loss volume and fluoroscopy time. No statistical difference was found in their fracture healing time, postoperative Harris scores, and malunion rate. The use of a Traction repositor could reduce the set-up time [SMD, − 2.48; 95% CI (− 4.91, − 0.05); P < 0.00001]. Conclusions Compared with manual traction, the traction table in femoral intramedullary nailing surgery lengthened operative time and preoperative set-up time. At the same time, it did not show significant advantages in reducing blood loss volume and fluoroscopy time, or improving prognosis. In clinical practice, the optimal surgical plan must be made on a case-by-case basis to avoid unnecessary traction table use.

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Is proximal femoral nailing of unstable intertrochanteric fractures in the lateral decubitus position without a traction table as safe and effective as on a traction table?

Cited by 14 publications

References 21 publications

Effect of Low-Dose Dexmedetomidine Combined with Lumbosacral Plexus Block Guided by Ultrasound Imaging Based on Image Segmentation Algorithm in Fracture Surgery

Effect of Low-Dose Dexmedetomidine Combined with Lumbosacral Plexus Block Guided by Ultrasound Imaging Based on Image Segmentation Algorithm in Fracture Surgery

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

Is the traction table necessary to treat femoral fractures with intramedullary nailing? A meta-analysis

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