Preoperative Traction And No Traction Treat Hip Fracture, A Systematic Review

Background With the aging population and the yearly increase in traffic injuries, hip fractures have become common in the field of orthopedic trauma and one of the challenging fractures.Since older osteoporosis and aging of the whole body system functions, hip fractures is an important reason which is leading to disability and even death in patients.Preoperative skin traction is a conventional methods of braking in the hip fractures.However, the efficacy of preoperative skin traction has been much controversy.There is no systematic review about preoperative traction treatment for the hip fractures.Objective To assess the effects of preoperative traction for the treatment of hip fracture.Methods It searched related database and identified randomized controlled trials or quasi-randomize controlled trials of preoperative traction versus no traction treatment for the hip fractures. It evaluated the quality of the included studies by handbook 4.2.6, which recommend by Cochrane Collaboration. The data analysis was conducted by using Rev Man 4.2.10.Results Seven randomized controlled trials (n=1000) were included. The Meta analysis showed that there were no significant difference between two groups in analgesic drug[OR=1.28,95%CI (0.87,1.89), P=0.21], pain relief scores[WMD=-0.31,95%CI (-0.90,0.29), P=0.31] and reduction[OR=0.92,95%CI (0.34,2.48), P=0.88]. Conclusion The present study showed that there were no difference between preoperative traction and no traction in the clinical efficacy and safety. Preoperative traction have not reduced pain at the fracture site whilst the patient is waiting for surgery, and have not advantage in reduction. Further high quality and large sample randomized controlled trials should be carried out.