Distal Femur Extraarticular fracture, simple

Provisional treatment; temporary skeletal traction

Temporary skeletal traction

Indication summary: Displaced open fracture, medically unfit patient

Skill: Some specialized surgical experience
Equipment: Simple surgical and imaging resources

In occasional cases, a period of nonoperative treatment may be necessary before the patient’s general condition, or the local status of the soft-tissues, will permit safe surgery. In these circumstances, a short period of skeletal traction can be used.

Skeletal traction does not allow for mobilization of the patient and may give rise to soft-tissue concerns about future incisions.

Indications

  • Patient in extremis
  • Severe local soft-tissue compromise
  • Significant deformity, without operative management

Contraindications

  • Safe definitive fixation possible
  • Associated vascular or neurological injury

Advantages

  • Easy to apply
  • Minimally invasive and safe procedure

Disadvantages

  • Pin loosening and track sepsis
  • Pressure sores
  • Potential knee stiffness
  • Increased patient discomfort and immobility

Legend

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

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v1.0 2008-12-03