University of Health and Allied Sciences, Surgery, Ho Teaching Hospital, Ho.
Department of Trauma and Orthopaedics, Korle Bu Teaching Hospital, Korle Bu - Accra.
Ghana Med J. 2020 Sep;54(3):146-150. doi: 10.4314/gmj.v54i3.4.
This study is to compare the outcomes of pre-operative skeletal and skin traction in adult femoral shaft fractures awaiting surgical fixation within two weeks of presentation to the Accident Center of Korle Bu Teaching Hospital.
This study was a clinical trial on 86 recruited patients with closed femoral shaft fractures sustained within 24 hours of presentation grouped into 2 groups. Descriptive and inferential statistics comprising frequency, percentage, Chi-square, independent sample t-test and Mann-Whitney U test were used in analysing the data.
Of the total number of patients involved in the study, 74% (n=64) were males and 26% (n=22) were females with a mean age of 39.49 (SD ±15). There was no statistically significant difference in the mean visual analogue scale (VAS) pain assessment between the Skin traction group and Trans-tibia skeletal traction group after traction. With regards to complications, the difference between the Skin traction group and the Skeletal traction group was statistically significant (P=0.001). Moreover, the mean blood loss compared with the open type of reduction in the Transtibia skeletal traction group was significantly less than the Skin traction group (p=0.000).
This study has shown that both Skeletal traction and Skin traction were equally effective in controlling pre-operative pain in adult patients with femoral shaft fractures and does not affect intra-operative blood loss and post-operative management. Therefore, pre-operative Skin traction can be considered a useful and cost-effective method of maintaining alignment and pain relief in adult femoral shaft fractures.
Personal Funding.
本研究旨在比较术前骨骼和皮肤牵引在成人股骨干骨折患者中的治疗效果,这些患者在伤后两周内需要接受手术固定。
这是一项在 Korle Bu 教学医院事故中心就诊的 86 名闭合性股骨干骨折患者中进行的临床试验,患者在伤后 24 小时内被分为两组。采用描述性和推断性统计方法,包括频率、百分比、卡方检验、独立样本 t 检验和曼-惠特尼 U 检验来分析数据。
在研究涉及的患者总数中,74%(n=64)为男性,26%(n=22)为女性,平均年龄为 39.49(SD±15)。在牵引后,皮肤牵引组和胫骨经皮骨牵引组的平均视觉模拟评分(VAS)疼痛评估之间没有统计学上的显著差异。关于并发症,皮肤牵引组和骨骼牵引组之间的差异具有统计学意义(P=0.001)。此外,胫骨经皮骨牵引组的术中出血量与开放复位相比明显少于皮肤牵引组(p=0.000)。
本研究表明,骨骼牵引和皮肤牵引在控制成人股骨干骨折患者术前疼痛方面同样有效,且不会影响术中出血量和术后管理。因此,术前皮肤牵引可以被认为是一种维持成人股骨干骨折对线和缓解疼痛的有效且具有成本效益的方法。
个人基金。