Distal Femur Extraarticular fracture, wedge

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 temporary skeletal traction may be necessary before the patient’s general condition, or the local status of the soft-tissues, will permit safe surgery.

Skeletal traction may give rise to soft-tissue concerns about future incisions.

Indications

  • Patient in extremis
  • Severe local soft-tissue compromise
  • Significant shortening, or angulation, without operative management

Contraindications

  • Safe definitive fixation possible
  • Associated vascular and/or neurological injury

Advantages

  • Easy to apply
  • Quick and safe procedure

Disadvantages

  • Pressure sores
  • Potential knee stiffness
  • Increased patient discomfort and immobility
  • Pin track problems may compromise future open surgery

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