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Article

Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation

1
Department of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, Switzerland
2
AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos Platz, Switzerland
3
Werner Siemens Foundation Endowed Chair for Innovative Implant Development, Clinics and Institutes of Surgery, Saarland University, 66421 Homburg, Germany
4
Department of Trauma, Hand and Reconstructive Surgery, Saarland University Hospital, 66421 Homburg, Germany
5
Department of Orthopaedic Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
6
Department of Plastic and Hand Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, Switzerland
7
Department of Plastic and Hand Surgery, University Hospital Zürich, Rämistraße 100, 8091 Zürich, Switzerland
8
Department of Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
9
Department of Orthopaedic and Emergency Surgery, Alfried Krupp Hospital, 45131 Essen, Germany
*
Author to whom correspondence should be addressed.
Equally contributed.
Academic Editor: Zsolt J. Balogh
Medicina 2021, 57(9), 884; https://doi.org/10.3390/medicina57090884
Received: 1 July 2021 / Revised: 17 August 2021 / Accepted: 20 August 2021 / Published: 27 August 2021
(This article belongs to the Special Issue Hip and Fragility Fracture Management)
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. View Full-Text
Keywords: microcirculation; traction table; traction; trochanteric; femur; fracture; blood flow; saturation; hemoglobin; laser-Doppler spectrophotometry; soft-tissue microcirculation; traction table; traction; trochanteric; femur; fracture; blood flow; saturation; hemoglobin; laser-Doppler spectrophotometry; soft-tissue
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MDPI and ACS Style

van Knegsel, K.P.; Ganse, B.; Haefeli, P.C.; Migliorini, F.; Scaglioni, M.F.; van de Wall, B.J.M.; Kim, B.-S.; Link, B.-C.; Beeres, F.J.P.; Nebelung, S.; Schoeneberg, C.; Hildebrand, F.; Gueorguiev, B.; Knobe, M. Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation. Medicina 2021, 57, 884. https://doi.org/10.3390/medicina57090884

AMA Style

van Knegsel KP, Ganse B, Haefeli PC, Migliorini F, Scaglioni MF, van de Wall BJM, Kim B-S, Link B-C, Beeres FJP, Nebelung S, Schoeneberg C, Hildebrand F, Gueorguiev B, Knobe M. Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation. Medicina. 2021; 57(9):884. https://doi.org/10.3390/medicina57090884

Chicago/Turabian Style

van Knegsel, Kenneth P., Bergita Ganse, Pascal C. Haefeli, Filippo Migliorini, Mario F. Scaglioni, Bryan J. M. van de Wall, Bong-Sung Kim, Björn-Christian Link, Frank J. P. Beeres, Sven Nebelung, Carsten Schoeneberg, Frank Hildebrand, Boyko Gueorguiev, and Matthias Knobe. 2021. "Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation" Medicina 57, no. 9: 884. https://doi.org/10.3390/medicina57090884

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