Lateral Decubitus vs Traction in the Supine Position in Proximal Femoral Nailing. Is There a Huge Difference?

Ain Shams University77 enrolled

Overview

This study is designed to compare two positions in the management of unstable intertrochanteric femur fractures. It's to compare the traditional supine position using a traction table and lateral decubitus. This study is designed to Compare between The accuracy of reduction In both methods, in addition,the radiological exposure and other secondary outcomes, like the blood loss, are compared.

To compare the fluoroscopic exposure time, quality of radiographic reduction, intra operative blood loss, setup time and surgical time between the lateral decubitus position and the use of a traction table in supine position in fixation of unstable intertrochanteric femur fractures by proximal femoral nail.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Unstable Intertrochanteric Fracture

Interventions

lateral decubitus postion during proximal femoral nailing for unstable intertrochnateric femur fracturesPROCEDURE

different positions of the patient during the surgery

Proximal femoral nailing for unstable intertrochnateric femur fractures in supine psoition using traction tablePROCEDURE

different positions for the proximal femoral nailing

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Skeletally mature patients * Unstable intertrochanteric fracture ( AO/OTA type 31A2 \& 31A3 ) Exclusion Criteria: * Patients unfit for surgery * Revision cases * Patients with multiple or pathological, neglected or open fractures.

Locations (1)

Ain Shams University Hospitals

Cairo, Egypt

Outcomes

Primary Outcomes

Quality of radiographic reduction

Optimum Tip-to-apex distance (TAD) is 25mm or less. * Normal femoral neck shaft angle between 125 and 145 degree. * The Baumgartner reduction quality criteria : - 1. Criterion one (alignment) : 1. Anterior posterior view : normal or slight valgus neck shaft angle 2. lateral view : less than 20 degree of angulation (Slight valgus means a valgus of no more 10 degrees) 2. Criterion two (displacement) : 1. Anterior posterior view: less than 4 mm of displacement of any fragment. 2. Lateral view: less than 4 mm of displacement of any fragment. 3. The reduction will be categorized as good if both criteria were met, acceptable if only one criterion was met, and poor if Neither criterion was met.

Time frame: immediate postoperative

Fluoroscopic exposure time

The fluoroscopic exposure time is defined as: The total duration of fluoroscopy use in minutes during the set up and the surgical procedure.

Time frame: intraoperative

Secondary Outcomes

Setup time

The period between the moment of transfer of the patient from the anesthesia team to the surgical team till the time of incision. This period includes placement of the patient on the surgical table or the traction table, preparation, and draping. The reduction and use of fluoroscopy during the reduction will be included within this time frame.

Time frame: Intraoperative

Surgical time

The time between the skin incision and the closure of the wound.

Time frame: Intraoperative

Data from ClinicalTrials.gov

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