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Traction methods in the retrograde intramedullary nailing of femur shaft fractures: the double reverse traction repositor or manual traction

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Abstract

Objective

The purpose of this prospective study was to compare the double reverse traction repositor (DRTR) and manual traction in retrograde intramedullary nailing (RE-IMN) for femoral shaft fractures.

Patients and methods

Seventy-seven patients with femur shaft fractures were randomized to undergo surgery with either DRTR or manual traction (MT) to facilitate RE-IMN between January 2018 and January 2019. Demographics, fracture characteristics, surgical data, post-operative complications, and functional outcomes were assessed. Data from 72 patients completing the final follow-up (12 months) were analysed in this study.

Results

The average number of intra-operative perspectives in the DRTR group was 27.7, which was significantly reduced compared with that in the MT group (31.3, p < 0.001). Fewer assistants were required in the DRTR group compared with the MT group (1.1 vs 1.9, p < 0.001). Fewer patients with open reduction were discovered in the DRTR group compared with the MT group (2.8 vs 19.4, p=0.024). Demographics, fracture characteristics, other surgical data, and prognostic parameters were comparative between the two groups.

Conclusions

The DRTR can be effectively and safely used to treat femur shaft fractures with RE-IMN. The DRTR achieves similar results as MT and is also superior to MT in terms of intra-operative perspectives, the number of assistants, and the open reduction rate.

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Acknowledgments

We thank JL Guo of the Department of Orthopaedics of Statistics and Applications for their generous assistance.

Availability of data and materials

Not applicable.

Funding

The study was funded by National Key R&D Program of China (Grant No. 2019YFC0120600).

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Kuo Zhao, Xiaodong Lian, Siyu Tian, Zhongzheng Wang, Junzhe Zhang, Junyong Li, Wei Chen, Zhiyong Hou & Yingze Zhang

  2. Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Kuo Zhao, Xiaodong Lian, Siyu Tian, Zhongzheng Wang, Junzhe Zhang, Junyong Li, Wei Chen, Zhiyong Hou & Yingze Zhang

  3. Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Kuo Zhao, Xiaodong Lian, Siyu Tian, Zhongzheng Wang, Junzhe Zhang, Junyong Li, Wei Chen, Zhiyong Hou & Yingze Zhang

  4. NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, China

    Zhiyong Hou & Yingze Zhang

  5. Chinese Academy of Engineering, Beijing, 10088, People’s Republic of China

    Yingze Zhang

Authors
  1. Kuo Zhao
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  2. Xiaodong Lian
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  3. Siyu Tian
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  7. Wei Chen
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Contributions

YZ Z designed the study; KZ, XD L, SY T, ZZ W, and JZ Z searched relevant studies; JY L and WC analysed and interpreted the data; KZ wrote the manuscript; and YZ Z and ZY H approved the final version of the manuscript.

Corresponding author

Correspondence to Yingze Zhang.

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Ethics approval

Implementation of this study was agreed by the Institutional Review Board of Third Hospital of Hebei Medical University.

Consent to participate

All patients provided informed consent prior to participating.

Consent for publication

Informed consent for publication was obtained from all patients.

Competing interests

The authors declare no competing interests.

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Zhao, K., Lian, X., Tian, S. et al. Traction methods in the retrograde intramedullary nailing of femur shaft fractures: the double reverse traction repositor or manual traction. International Orthopaedics (SICOT) 45, 2711–2718 (2021). https://doi.org/10.1007/s00264-021-04961-2

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