Resch S, Thorngren K G
Department of Orthopedics, University Hospital, Lund, Sweden.
Acta Orthop Scand. 1998 Jun;69(3):277-9. doi: 10.3109/17453679809000929.
153 consecutive patients with displaced cervical and trochanteric hip fractures were considered for inclusion in this study. 75 were excluded because of senile confusion and the remaining 78 were randomized to skeletal or skin traction preoperatively. The effect on pain alleviation was evaluated with a Visual Analogue Scale (VAS) and by the number of doses of analgesics administered. The processing time through the emergency department, radiographic department and to the ward, as well as time to operation, was registered. No significant difference in the VAS pain evaluation was found. There was a small significant increase in consumption of analgesics of no clinical importance in patients with skin traction, and no effect of traction type on the processing time or time to operation. Fracture type did not affect the outcome. Since half of the patients found the application of skeletal traction painful, compared to one fifth with skin traction, skeletal traction should not be routinely used to alleviate pain preoperatively in these patients.
本研究纳入了153例伴有移位的颈椎和股骨转子间骨折患者。75例因老年痴呆被排除，其余78例患者术前随机分为骨牵引组或皮牵引组。采用视觉模拟评分法（VAS）和使用镇痛剂的剂量评估疼痛缓解效果。记录患者通过急诊科、放射科到病房的处理时间以及手术时间。VAS疼痛评估未发现显著差异。皮牵引患者的镇痛剂消耗量有小幅显著增加，但无临床意义，牵引类型对处理时间或手术时间无影响。骨折类型不影响结果。由于与五分之一的皮牵引患者相比，一半的骨牵引患者觉得骨牵引应用时疼痛，因此在这些患者中，骨牵引不应常规用于术前缓解疼痛。
