title: Efficacy of preoperative skin traction for hip fractures: a single-institution prospective randomized controlled trial of skin traction versus no traction.
abstract: BACKGROUND
  Preoperative traction for hip fractures is of no benefit in semi-urgent surgery. However, its efficacy has not been assessed in cases in which emergency surgery was not possible. We evaluated the efficacy of preoperative skin traction for hip fractures in a level II trauma center in Japan where many patients undergo delayed surgery.
  
  
  METHODS
  We undertook a randomized controlled trial. Eighty-one patients were randomized to be treated with skin traction (41 patients), or bed rest (40 patients). Preoperative pain was assessed by use of a visual analogue scale and the number of analgesics required. Fracture reduction was measured on the basis of leg-length and neck-shaft angle discrepancies on the radiograph on admission, a day before surgery, and after surgery.
  
  
  RESULTS
  The mean time from admission to surgery was 7.5 days. Pain decreased markedly on the day after admission in both the traction and no-traction groups. No significant difference was found during the preoperative waiting period between the groups in either pain score or number of analgesics taken. No significant difference was found in radiographic data either before or after surgery, and satisfactory reduction was achieved after surgery irrespective of the use of skin traction.
  
  
  CONCLUSIONS
  In our single-institution prospective randomized controlled trial, preoperative skin traction for patients with hip fracture had no effect on pain relief before surgery or reduction of fracture displacement during surgery, irrespective of preoperative waiting time.
authors.affiliation: Department of Orthopaedic Surgery, Japanese Red Cross Narita Hospital, 90-1 Iida-cho, Narita, Chiba 286-8523, Japan. orthopaedics@hotmail.co.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Endo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Masahito
authors.initials: M
authors.lastname: Saito
authors.forename: Takashi
authors.initials: T
authors.lastname: Itabashi
authors.forename: Kouji
authors.initials: K
authors.lastname: Kita
authors.forename: Wataru
authors.initials: W
authors.lastname: Koizumi
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Tomomi
authors.initials: T
authors.lastname: Asaka
authors.forename: Osamu
authors.initials: O
authors.lastname: Saegusa
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D000704:Analysis of Variance; D001510:Bed Rest; D016009:Chi-Square Distribution; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007564:Japan; D008297:Male; D010147:Pain Measurement; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014143:Traction / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics