Abstract
Background and Objectives: Wound infections provoked by alterations in microcirculation are major complications in the treatment of trochanteric femur fractures. Surgical fracture fixation on a traction table is the gold standard for treatment, but the effect on tissue microcirculation is unknown. Microcirculation could be impaired by the pull on the soft-tissue or by a release of vasoactive factors. We hypothesized that intraoperative traction impairs soft-tissue microcirculation. Materials and Methods: In 22 patients (14 women, eight men), average age 78 years (range 36–96 ± 14), with trochanteric femur fractures, non-invasive laser-Doppler spectrophotometry was used to assess oxygen saturation, hemoglobin content, and blood flow in the skin and subcutaneous tissue before and after application of traction. Measurements were recorded in nine locations around the greater trochanter at a depth of 2, 8, and 15 mm before and after fracture reduction by traction. Results: No differences were found in any depth with traction compared to without (oxygen saturation: p = 0.751, p = 0.308, and p = 0.955, haemoglobin content: p = 0.651, p = 0.928, and p = 0.926, blood flow: p = 0.829, p = 0.866, and p = 0.411). Conclusion: In this pilot study, the application of traction does not affect skin and subcutaneous microcirculation in the surgery of proximal femur fractures.
Highlights
Proximal femur fractures are among the most common fractures worldwide and have a major impact on healthcare systems [1,2]
Four patients were performed on the traction table
The findings of the present study indicate no differences in microcirculation
Summary
Proximal femur fractures are among the most common fractures worldwide and have a major impact on healthcare systems [1,2]. Despite multiple treatment options, improved implants, advanced research and knowledge, the two year mortality rate in these old and Proximal femur fractures are among the most common fractures worldwide and have a major impact on healthcare systems [1,2]. Among the high relevant mortalitytorate post-operative complications, such as complications, surgical-site infections, factors theare high mortality rate are post-operative such as nonunion, deep vein thrombosis, increased morbidity [1,6,7]. Closed reduction and surgical-site infections, nonunion,and deep vein thrombosis, and increased morbidity internal fixation (CRIF).
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