title: Skeletal versus skin traction before definitive management of pediatric femur fractures: a comparison of patient narcotic requirements.
abstract: BACKGROUND
  Pediatric patients with femoral shaft fractures are often placed in traction as a temporizing measure before definitive management. The purpose of our study was to compare narcotic use in pediatric patients with isolated femoral shaft fractures that were initially treated with skeletal traction with similar patients that were initially treated with skin traction. The hypothesis was that narcotic use would not be significantly different between the groups.
  
  
  METHODS
  Chart review at 2 institutions was carried out to identify pediatric patients with isolated femoral shaft fractures treated with either skeletal traction or skin traction. The patients' age, weight, and the amount and duration of narcotic use were recorded. A 2-sample t test was used for the comparison.
  
  
  RESULTS
  Fifty-one patients were treated with skin traction and 24 patients were treated with skeletal traction. Patients in the skeletal traction group used more pain medication (0.0177 mg/kg/h in traction) than those in the skin traction group (0.0137 mg/kg/h in traction), but this was not statistically significant (P=0.1031).
  
  
  CONCLUSIONS
  The findings support our hypothesis that the amount of narcotics used between the skeletal traction group and skin traction group would not be significantly different. In using narcotic requirement as a gross measure of patient comfort while in traction, it seems there may be no benefit to the patient to have invasive skeletal traction while awaiting definitive management of their fracture.
  
  
  METHODS
  Retrospective comparative study, level III.
authors.affiliation: Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, MI 49008-1202, USA. vanlaningham@kcms.msu.edu
authors.forename: Cameron J
authors.initials: CJ
authors.lastname: Vanlaningham
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Schaller
authors.forename: Christopher
authors.initials: C
authors.lastname: Wise
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005264:Femoral Fractures / Q000150:complications / Q000628:therapy*; D005596:Fractures, Closed / Q000628:therapy; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D012867:Skin; D014143:Traction / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid