The effectiveness of skin traction in reducing pain in adults with a hip fracture : a systematic review

Abstract

Background: Femoral fractures are associated with high mortality and morbidity, including pain. Skin traction may be used pre-operatively as an adjunct to analgesia to decrease pain. Objective: To evaluate the effects on pain of the use of pre-operative skin traction in adults with a fracture of the proximal femur. Research question: Is the use of pre-operative skin traction effective in reducing pain in adults with proximal femoral fractures? Method: A systematic review was conducted based on a search of PubMed, CINAHL Complete, MEDLINE Complete, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews. The keywords ‘preoperative’, ‘skin traction’, ‘hip fractures’ and ‘pain’ were used. Randomised controlled trials published in English between April 2011 and November 2020 were included and appraised using the Cochrane Risk of Bias tool. Results: Five articles met the inclusion criteria; all were randomised controlled trials. The results confirm those of earlier reviews: skin traction does not significantly decrease pain and analgesia use. The quality of the evidence available is weak. Conclusion: There is no strong evidence for the routine pre-operative use of skin traction in adults with a hip fracture. As the quality of the evidence is weak, further high-quality research on this topic is warranted.