• Kenneth P van Knegsel, Bergita Ganse, Pascal C Haefeli, Filippo Migliorini, Mario F Scaglioni, van de WallBryan J MBJMDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, Switzerland., Bong-Sung Kim, Björn-Christian Link, Frank J P Beeres, Sven Nebelung, Carsten Schoeneberg, Frank Hildebrand, Boyko Gueorguiev, and Matthias Knobe.
• Department of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, Switzerland.
• Medicina (Kaunas). 2021 Aug 27; 57 (9).

AbstractBackground 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.

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