Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation
<i>Background and Objectives</i>: 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 microcircul...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/9/884 |
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| author | Kenneth P. van Knegsel 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 Matthias Knobe |
| author_facet | Kenneth P. van Knegsel 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 Matthias Knobe |
| author_sort | Kenneth P. van Knegsel |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: No differences were found in any depth with traction compared to without (oxygen saturation: <i>p =</i> 0.751, <i>p =</i> 0.308, and <i>p =</i> 0.955, haemoglobin content: <i>p =</i> 0.651, <i>p =</i> 0.928, and <i>p =</i> 0.926, blood flow: <i>p =</i> 0.829, <i>p =</i> 0.866, and <i>p =</i> 0.411). <i>Conclusion</i>: In this pilot study, the application of traction does not affect skin and subcutaneous microcirculation in the surgery of proximal femur fractures. |
| first_indexed | 2024-03-10T07:28:07Z |
| format | Article |
| id | doaj.art-841d54fcc0f34f78abc7922fd0a3cb22 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T07:28:07Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-841d54fcc0f34f78abc7922fd0a3cb222023-11-22T14:07:44ZengMDPI AGMedicina1010-660X1648-91442021-08-0157988410.3390/medicina57090884Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue MicrocirculationKenneth P. van Knegsel0Bergita Ganse1Pascal C. Haefeli2Filippo Migliorini3Mario F. Scaglioni4Bryan J. M. van de Wall5Bong-Sung Kim6Björn-Christian Link7Frank J. P. Beeres8Sven Nebelung9Carsten Schoeneberg10Frank Hildebrand11Boyko Gueorguiev12Matthias Knobe13Department of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, SwitzerlandWerner Siemens Foundation Endowed Chair for Innovative Implant Development, Clinics and Institutes of Surgery, Saarland University, 66421 Homburg, GermanyDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, SwitzerlandDepartment of Orthopaedic Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, GermanyDepartment of Plastic and Hand Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, SwitzerlandDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, SwitzerlandDepartment of Plastic and Hand Surgery, University Hospital Zürich, Rämistraße 100, 8091 Zürich, SwitzerlandDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, SwitzerlandDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, SwitzerlandDepartment of Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, GermanyDepartment of Orthopaedic and Emergency Surgery, Alfried Krupp Hospital, 45131 Essen, GermanyDepartment of Orthopaedic Surgery, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, GermanyAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos Platz, SwitzerlandDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital of Lucerne, Spitalstraβe 16, 6000 Lucerne, Switzerland<i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: No differences were found in any depth with traction compared to without (oxygen saturation: <i>p =</i> 0.751, <i>p =</i> 0.308, and <i>p =</i> 0.955, haemoglobin content: <i>p =</i> 0.651, <i>p =</i> 0.928, and <i>p =</i> 0.926, blood flow: <i>p =</i> 0.829, <i>p =</i> 0.866, and <i>p =</i> 0.411). <i>Conclusion</i>: In this pilot study, the application of traction does not affect skin and subcutaneous microcirculation in the surgery of proximal femur fractures.https://www.mdpi.com/1648-9144/57/9/884microcirculationtraction tabletractiontrochantericfemurfracture |
| spellingShingle | Kenneth P. van Knegsel 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 Matthias Knobe Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation Medicina microcirculation traction table traction trochanteric femur fracture |
| title | Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation |
| title_full | Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation |
| title_fullStr | Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation |
| title_full_unstemmed | Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation |
| title_short | Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation |
| title_sort | trochanteric femur fractures application of skeletal traction during surgery does not alter soft tissue microcirculation |
| topic | microcirculation traction table traction trochanteric femur fracture |
| url | https://www.mdpi.com/1648-9144/57/9/884 |
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