Prospective randomized trial of homeopathic traction reduction technique for femoral shaft fracture

Objective To explore whether the homeopathic traction reduction technique can provide better traction reduction for femoral shaft fractures with femoral intramedullary nailing, and improve the efficiency of surgery and reduce the surgical trauma. Methods Sixty cases of femoral shaft fractures treated by closed or limited open reduction and intramedullary nailing were prospectively collected from January 2016 to September 2017 in Shanghai Tenth People's Hospital. They were divided into homeopathic traction group and traction table group randomly using computer random number method, 30 cases in each. The homeopathic traction group used the homeopathic double reverse traction device, while traction table group used a standard orthopaedic traction table. Obvervational index including the preoperative and postoperative X-ray, VAS score, SF-36 score, operation time, Intraoperative blood loss, perioperative blood loss and incision length, femoral deformity degree. Results All 60 cases received well follow-up and the rate was 100%. Homeopathic traction group all achieved closed or limited open reduction, 26 cases in traction table group receives closed or limited open reduction, 4 cases changed to open reduction, the incidence of difficult to reset in homeopathic traction group was lower than the traction table group, there was statistical significance (χ2=4.286, P=0.038). The operation time of the homeopathic traction group [(121±22)min] was shorter than that of the traction table group [(147±31)min, t=3.746, P<0.001]. The blood loss and perioperative blood loss in the homeopathic traction group [(320±50)ml, (423±115)ml] were less than the traction table group [(410±55)ml, (474±100)ml, t=6.632, t=1.833, P<0.001, P=0.073). Conclusions Double reverse traction technique can provide traction direction parallel to lower limb alignment. More convenient and accurate to adjustment such as Varus-valgus angle and rotating angle. It also could provide enough traction strength, which could significantly improve the efficiency and accuracy of reduction. Double reverse traction technique can reduce the intraoperative blood loss, shorten the operation time, it is an excellent technology worth promotion. Key words: Femoral fractures; Suigical procedures, minimally invasive; Homeopathic bidirectional-tration reduction device