BACKGROUND: Pre-operative traction following an acute @entity173 remains standard practice in some hospitals. OBJECTIVES: To evaluate the effects of traction applied to the injured limb prior to surgery for a @entity173 . Different methods of applying traction (skin or skeletal) were considered. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group's specialised register (February 2003), the Cochrane Controlled Trials Register (The Cochrane Library Issue 1, 2003), MEDLINE (1966 to February 2003), EMBASE (1988 to 2003 Week 8), CINAHL (1982 to February 2003), the National Research Register Issue 1, 2003, conference proceedings and reference lists of articles. Date of most recent search: February 2003. SELECTION CRITERIA: All randomised or quasi-randomised trials comparing either skin or skeletal traction with no traction, or skin with skeletal traction for @entity1 with an acute @entity173 prior to surgery. DATA COLLECTION AND ANALYSIS: Both reviewers independently assessed trial quality, using a nine item scale, and extracted data. Additional information was sought from all trialists. Wherever appropriate and possible, the data are presented graphically. MAIN RESULTS: Eight randomised trials, mainly of moderate quality, involving a total of 1349 predominantly elderly @entity1 , were identified and included in the review. The inclusion in this review update of a newly available trial resulted in no important change in the results or conclusions. Seven trials compared traction with no traction. Although no data pooling was possible, overall these provided no evidence of benefit from traction, either in the relief of @entity158 , ease of @entity174 reduction or quality of @entity174 reduction at time of surgery. One of these trials included both skin and skeletal traction groups. This trial and one other compared skeletal traction with skin traction and found no important differences between these two methods, although the initial application of skeletal traction was noted as being more @entity158 and more costly. REVIEWER'S CONCLUSIONS: From the evidence available, the routine use of traction (either skin or skeletal) prior to surgery for a @entity173 does not appear to have any benefit. However, the evidence is also insufficient to rule out the potential advantages for traction, in particular for specific @entity174 types, or to confirm additional complications due to traction use. Further, high quality trials would be required to confirm or refute the absence of benefits of traction.

Pre-operative traction for XXXX of the proximal femur.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity173 :: ('MESH:D006620', 'Disease') :: ['hip fracture', 'fractured hip'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain', 'painful']
@entity174 :: (MESH:D050723,Disease) :: ['fractures']
