title: Traction table versus manual traction in the intramedullary nailing of unstable intertrochanteric fractures: A prospective randomized trial.
abstract: BACKGROUND
  The purpose of this prospective randomized study was to compare traction table with manual traction for the reduction and nailing of unstable intertrochanteric femur fractures.
  
  
  METHODS
  Prospective, randomized, two-center trial.
  
  
  METHODS
  72 elderly patients with AO/OTA 31A2 and 31A3 proximal femur fractures were randomized to undergo surgery with either manual traction (MT) or traction table (TT) facilitated intramedullary nailing. The demographics and fracture characteristics, duration of preparation and surgery, total anaesthesia time, fluoroscopy time, blood loss, number of assistants, early post-operative radiological evaluations and 6th month functional and radiological outcomes were evaluated. Data of 64 patients attending 6th month follow-up examination were evaluated statistically.
  
  
  RESULTS
  No significant differences were observed between groups regarding demographics and fracture characteristics. In the manual traction group, there was a significant time gain in respect of the positioning and preparation period (18.0±1.6min in MT group, 29.0±2.4min in TT group) (p<0.05). In terms of total anaesthesia time (Preparation+surgery) approximately 6min of difference was observed in favor of MT group (72.8±14.0min for MT and 78.6±6.5min for TT, [p<0.05]). Median number of assistants needed was significantly lower in TT group (2 assistants [1-3]) in MT group and (1 assistant [1,2]) in TT group [p<0.05]). There was no significant difference between two groups regarding other surgical and outcome parameters.
  
  
  CONCLUSIONS
  Manual traction reduced the preparation time and total anaesthesia duration, despite an increase in number of surgical assistant.
  
  
  METHODS
  Level II.
authors.affiliation: Bülent Ecevit University, Faculty of Medicine, Department of Orthopedics& Traumatology, Zonguldak, Turkey. Electronic address: dr_erc_sah@yahoo.com.tr.
authors.forename: Ercan
authors.initials: E
authors.lastname: Şahin
authors.affiliation: Bülent Ecevit University, Faculty of Medicine, Department of Orthopedics& Traumatology, Zonguldak, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Songür
authors.affiliation: Ankara University, Faculty of Medicine, Department of Orthopedics& Traumatology, Ankara, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Kalem
authors.affiliation: Hitit University, Faculty of Medicine, Department of Orthopedics& Traumatology, Çorum, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Zehir
authors.affiliation: Yıldırım Beyazıt University, Faculty of Medicine, Department of Orthopedics& Traumatology, Ankara, Turkey.
authors.forename: Mehmet Atıf Erol
authors.initials: MA
authors.lastname: Aksekili
authors.affiliation: Bülent Ecevit University, Faculty of Medicine, Department of Orthopedics& Traumatology, Zonguldak, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Keser
authors.affiliation: Bülent Ecevit University, Faculty of Medicine, Department of Orthopedics& Traumatology, Zonguldak, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bayar
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods; D006620:Hip Fractures / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D058638:Operating Tables; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery*; D011446:Prospective Studies; D016683:Supine Position; D014143:Traction / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
keywords: Intertrochanteric fracture; Intramedullary nailing; Surgery; Traction