Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Xi'an Medical University, Xi'an, People's Republic of China.
Clin Interv Aging. 2023 Mar 10;18:387-395. doi: 10.2147/CIA.S399608. eCollection 2023.
Despite promising clinical outcome proposals, there has been relatively little published regarding the use of traction table-assisted 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.
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).
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.
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.
尽管有一些有前景的临床结果建议，但关于牵引桌辅助髓内钉植入治疗股骨转子间骨折的应用，相关文献报道相对较少。本研究的目的是进一步总结和评估已发表的临床研究，这些研究比较了使用牵引桌和不使用牵引桌治疗股骨转子间骨折的临床结果。
系统地使用 PubMed、Cochrane 图书馆和 Embase 进行全面的文献检索，以评估截至 2022 年 5 月纳入文献的所有研究。检索词包括“股骨转子间骨折”、“髋部骨折”和“牵引桌”，并使用布尔运算符“AND”和“OR”。提取并总结以下信息：人口统计学信息、设置时间、手术时间、出血量、透视曝光时间、复位质量和 Harris 髋关节评分（HHS）。
共有 8 项涉及 620 例患者的临床对照研究符合纳入标准。受伤时的平均年龄为 75.3 岁（牵引桌组 75.7 岁，非牵引桌组 74.9 岁）。非牵引桌组最常见的辅助髓内钉植入方法包括侧卧位（4 项研究）、牵引复位器（3 项研究）和手动牵引（1 项研究）。纳入的研究结果均表明，两组在复位质量和 Harris 髋关节评分方面没有差异，非牵引桌组在设置时间方面具有优势。然而，在手术时间、出血量和透视曝光时间方面仍存在争议。
对于股骨转子间骨折患者，不使用牵引桌辅助髓内钉植入与使用牵引桌同样安全有效，而且不使用牵引桌在设置时间方面可能更具优势。
