Use of Skeletal Traction in Distal 1/3rd Tibia Intraoperatively for Achieving Reduction in Proximal Tibia Fracture
Journal of Clinical Orthopaedics | Vol 9 | Issue 2 | July-December 2024 | page: 78-82 | Rajendraprasad Ramesh Butala, Sonali Das, Garvit Khatod
DOI: https://doi.org/10.13107/jcorth.2024.v09i02.674
Submitted Date: 02 Oct 2024, Review Date: 28 Oct 2024, Accepted Date: 01 Nov 2024 & Published Date: 10 Dec 2024
Author: Rajendraprasad Ramesh Butala [1], Sonali Das [1], Garvit Khatod [1]
[1] Department of Orthopaedics, DY Patil Hospital, Navi Mumbai, Maharashtra, India.
Address of Correspondence
Sonali Das,
Department of Orthopaedics, DY Patil Hospital, Navi Mumbai, Maharshtra, India.
Email: drsonalidas@hotmail.com
Abstract
Introduction: Skeletal traction is a technique used to manage fractures by applying continuous axial force directly to the bone through a pin inserted through it. This method is particularly useful in maintaining proper alignment of fracture fragments, reducing pain, and preventing muscle spasms. It is commonly employed in the management of long bone fractures, such as those of the femur, especially when immediate surgical intervention is not possible. Skeletal traction stabilizes the fracture, facilitating proper healing and often serving as a temporizing measure before definitive surgical fixation. This study focuses on skeletal traction applied for the reduction of proximal tibia fractures. Studies on this subject are lacking as most established data focuses on its use for shaft femur fractures.
Materials and Methods: This study was conducted in a tertiary care teaching hospital by a single skilled surgeon team on 30 skeletally mature patients. Skeletal traction was applied for each patient using a Steinmann pin and 15% of the patient body weight over distal 1/3rd tibia shaft immediately post-trauma for 1 week and continued intraoperatively during primary fixation as plating. Pre-operative and post-operative radiographs were taken. Knee range of motion was measured using a goniometer at 2 weeks, 1 month, 3 months, and 6 months post-operative. Serial radiographs were taken immediately, 1 month, 3 months, and 6 months post-operative.
Conclusion: Skeletal traction applied over the distal 1/3rd shaft tibia shows promising results for comminuted proximal tibia fractures. It reduces fracture fragment displacement commonly occurring during manual traction.
Keywords: Skeletal traction, Proximal tibia, Tibial fractures, Lower extremity trauma.
References
1. Elsoe R, Johansen MB, Larsen P. Tibial plateau fractures are associated with a long-lasting increased risk of total knee arthroplasty a matched cohort study of 7,950 tibial plateau fractures. Osteoarthritis Cartilage 2019;27:805-9.
2. Dendrinos GK, Kontos S, Katsenis D, Dalas A. Treatment of high-energy tibial plateau fractures by the Ilizarov circular fixator. J Bone Joint Surg Br 1996;78:710-7.
3. Young MJ, Barrack RL. Complications of internal fixation of tibial plateau fractures. Orthop Rev 1994;23:149-54.
4. Skin Traction and Skeletal Traction. Bone and Spine. 2019.
5. Matullo KS, Gangavalli A, Nwachuku C. Review of lower extremity traction in current orthopaedic trauma. J Am Acad Orthop Surg 2016;24:600-6.
6. Stephen DJ, Kreder HJ, Schemitsch EH, Conlan LB, Wild L, McKee MD. Femoral intramedullary nailing: Comparison of fracture-table and manual traction. A prospective, randomized study. J Bone Joint Surg Am 2002;84:1514-21.
7. Menghi A, Mazzitelli G, Marzetti E, Barberio F, D’Angelo E, Maccauro G. Complex tibial plateau fractures: A retrospective study and proposal of treatment algorithm. Injury 2017;48 Suppl 3:S1-6.
8. Krieg JC. Proximal tibial fractures: Current treatment, results, and problems. Injury 2003;34:A2-10.
9. Hu SJ, Chang SM, Zhang YQ, Ma Z, Du SC, Zhang K. The anterolateral supra-fibular-head approach for plating posterolateral tibial plateau fractures: A novel surgical technique. Injury 2016;47:502-7.
10. Hu S, Chen S, Chang S, Xiong W, Tuladhar R. Treatment of isolated posterolateral tibial plateau fracture with a horizontal belt plate through the anterolateral supra-fibular-head approach. Biomed Res Int 2020;2020:4186712.
11. Schneiderman BA, O’Toole RV. Compartment syndrome in high-energy tibial plateau fractures. Orthop Clin North Am 2022;53:43-50.
12. Hak DJ, Lee M, Gotham DR. Influence of prior fasciotomy on infection after open reduction and internal fixation of tibial plateau fractures. J Trauma 2010;69:886-8.
13. Dubina AG, Paryavi E, Manson TT, Allmon C, O’Toole RV. Surgical site infection in tibial plateau fractures with ipsilateral compartment syndrome. Injury 2017;48:495-500.
14. Paziuk T, Sutton R, McEntee R, Farronato D, Krieg J. Lateral femoral distraction is a safe and necessary adjunct for articulator visualization during the operative treatment of tibial plateau fractures. J Orthop 2022;33:44-7.
15. Wang Z, Lu Y, Wang Q, Song L, Ma T, Ren C, et al. Comparison of the effectiveness and safety of intravenous and topical regimens of tranexamic acid in complex tibial plateau fracture: A retrospective study. BMC Musculoskelet Disord 2020;21:739.
| How to Cite this article: Butala RR, Das S, Khatod G. Use of Skeletal Traction in Distal 1/3rd Tibia Intraoperatively for Achieving Reduction in Proximal Tibia Fracture. Journal of Clinical Orthopaedics 2024:July-December:9(2);78-82. |
(Article Text HTML) (Download PDF)
