Management of Femoral Shaft Fractures: The Significance of Traction or Operative Position
Notice bibliographique
Résumé
Background and objective Intramedullary femoral nailing (IMN) is the gold standard for managing femoral shaft fractures (FSFs). Though good clinical outcomes and union rates have been reported following this procedure, it has also been commonly associated with perioperative complications. Positioning the patient in lateral decubitus, avoiding a fracture table, or using manual traction have been touted as possible techniques to reduce perioperative complications in IMN. However, given the scarce availability of comparative research, the decision to employ any of the techniques mentioned above is often guided by surgeon preference alone. In light of this, the purpose of this study was to determine whether the use of free-leg draping using either supine or direct lateral positioning with manual traction reduces perioperative complications among trauma patients undergoing an anterograde femoral nailing surgery when compared to using a fracture table. Methods Consecutive adult patients from a level-one trauma center undergoing unilateral antegrade femoral fixation surgeries between 2016 and 2020 were retrospectively evaluated for possible inclusion in the study. Relevant perioperative and postoperative data, including length of hospital or ICU stay and perioperative complications, were included in the analysis. This study received research ethics board approval before data collection began. Results A total of 91 patients were ultimately included in the final analysis: 61 patients were included in the free-leg draping with manual traction group (FL) and 30 patients were included in the traction table group (TT). Patients in the FL group had a similar operative and fluoroscopy time, blood loss, length of stay, and time on the ventilator. Subgroup analysis comparing positioning within the FL group revealed non-significant differences in fluoroscopy time (p=0.59) and length of stay (p=0.20) between the lateral and supine groups. Moreover, no differences in operative time, blood loss, and time on the ventilator were observed between lateral and supine groups. Conclusion Based on our findings, there were no significant differences in terms of operative or fluoroscopy time, perioperative complications, or length of time in the hospital or on the ventilator between the groups. Our study was limited by its small sample size and incomplete data. Further prospective randomized research is required to reach definitive conclusions on the appropriate manner to treat patients with these complex and morbid injuries.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».