股骨骨折术前牵引用于疼痛管理：比较研究的荟萃分析
Pre-Operative Traction in Femoral Fractures for Pain Management: A Meta-Analysis of Comparative Studies.
作者信息
Tarchichi Jean, Daher Mohammad, Ghoul Ali, Estephan Michel, Mansour Jad
出版信息
Arch Bone Jt Surg. 2024;12(10):683-689. doi: 10.22038/ABJS.2024.78869.3622.
OBJECTIVES
This meta-analysis studies and assesses the pain relief effect of different pre-operative traction systems in proximal and femoral shaft fractures as this subject is still debated and no clear guidelines are established.
METHODS
PubMed, Cochrane, Embase and Google Scholar (page 1-20) were searched until January 2024. The clinical outcomes collected consisted of pain scales following traction.
RESULTS
Two randomized clinical trials were included to compare skeletal (72 patients) to skin traction (80 patients) and eight randomized clinical trials with one prospective study were included to compare traction (457 patients) versus no traction (439 patients). Our results revealed no differences in terms of post-operative pain VAS between both the skeletal and skin traction as well as between traction and no traction.
CONCLUSION
No added benefit of traction was observed when pain relief is the main consideration. Furthermore, with their different potential complications, systematic pre-operative traction should not be implemented in all femoral fractures.
目的
本荟萃分析旨在研究和评估不同术前牵引系统对股骨近端和股骨干骨折的止痛效果，因为该主题仍存在争议且尚未建立明确的指南。
方法
检索了截至2024年1月的PubMed、Cochrane、Embase和谷歌学术（第1 - 20页）。收集的临床结果包括牵引后的疼痛量表。
结果
纳入两项随机临床试验，比较骨骼牵引（72例患者）与皮肤牵引（80例患者），并纳入八项随机临床试验和一项前瞻性研究，比较牵引（457例患者）与不牵引（439例患者）。我们的结果显示，骨骼牵引与皮肤牵引之间以及牵引与不牵引之间，术后疼痛视觉模拟评分（VAS）均无差异。
结论
当主要考虑止痛时，未观察到牵引有额外益处。此外，鉴于其不同的潜在并发症，不应在所有股骨骨折中实施系统性术前牵引。
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