Use of Skeletal Traction in Distal 1/3rd Tibia Intraoperatively for Achieving Reduction in Proximal Tibia Fracture

Abstract

Introduction: Skeletal traction is a technique used to manage fractures by applying continuous axial force directly to the bone through a pin inserted through it. This method is particularly useful in maintaining proper alignment of fracture fragments, reducing pain, and preventing muscle spasms. It is commonly employed in the management of long bone fractures, such as those of the femur, especially when immediate surgical intervention is not possible. Skeletal traction stabilizes the fracture, facilitating proper healing and often serving as a temporizing measure before definitive surgical fixation. This study focuses on skeletal traction applied for the reduction of proximal tibia fractures. Studies on this subject are lacking as most established data focuses on its use for shaft femur fractures. Materials and Methods: This study was conducted in a tertiary care teaching hospital by a single skilled surgeon team on 30 skeletally mature patients. Skeletal traction was applied for each patient using a Steinmann pin and 15% of the patient body weight over distal 1/3rd tibia shaft immediately post-trauma for 1 week and continued intraoperatively during primary fixation as plating. Pre-operative and post-operative radiographs were taken. Knee range of motion was measured using a goniometer at 2 weeks, 1 month, 3 months, and 6 months post-operative. Serial radiographs were taken immediately, 1 month, 3 months, and 6 months post-operative. Conclusion: Skeletal traction applied over the distal 1/3rd shaft tibia shows promising results for comminuted proximal tibia fractures. It reduces fracture fragment displacement commonly occurring during manual traction. Keywords: Skeletal traction, Proximal tibia, Tibial fractures, Lower extremity trauma.

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