Does Traction Decrease the Need for Open Reduction in Femoral Shaft Fractures Treated Within 24 Hours?


This study evaluates whether preoperative skeletal traction reduces the need for open reduction in femoral shaft fractures treated with intramedullary nailing (IMN) within 24 hours. A retrospective review was conducted of femoral shaft fractures undergoing IMN within 1 day of admission. Primary outcome was an open reduction at the time of IMN. Secondary outcomes were blood loss and transfusion requirements. One hundred eighty-four patients were analyzed, 106 in the knee immobilizer group and 78 in the skeletal traction group. Skeletal traction did not reduce the need for an open reduction. The knee immobilizer group required open reduction in 13% (14/106) compared with 14% (11/78) in the skeletal traction group, which was not significant (p = .89). Blood loss and transfusion rates were similar between groups. Skeletal traction does not appear to reduce the need for open reduction at the time of IMN for femoral shaft fractures treated within 1 day of admission. (Journal of Surgical Orthopaedic Advances 27(4):303–306, 2018)
Key words: femur fracture, intramedullary nail, knee immobilizer, skeletal traction, temporary stabilization

Michael R. Koerner, MD; Lindsay E. Young, MD; Ashley Daniel, MD; Stephanie L. Tanner, MS; Brett Crist, MD; Thomas M. Schaller, MD; Kyle J. Jeray, MD; Michael S. Sridhar, MD; and John D. Adams, Jr., MD