AB022. SOH25_AB_128. Novel post-free traction technique provides safe surgical exposure in paediatric and adolescent and femur fracture surgery
Paediatric Session

AB022. SOH25_AB_128. Novel post-free traction technique provides safe surgical exposure in paediatric and adolescent and femur fracture surgery

Callum MacLeay1, Luke Beaton2, Karine Stoelben1, Kevin Smit1, Alicia Kerrigan2

1Division of Orthopaedic Surgery, Carsen Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada; 2Fowler Kennedy Sports Medicine Clinic, Western University, London, Ontario, Canada

Background: The traction table is used for numerous lower extremity procedures including hip and femur fractures, deformity correction, and hip arthroscopy. However, standard traction is not without risk; injuries are common and include neuropraxias, pressure injuries, well leg compartment syndrome, and rotational malreduction. This study aims to outline our experience using a post-free traction table in the management of paediatric femur fractures and report on early functional and radiographic outcomes and complications.

Methods: A retrospective review of consecutive patients treated with post-free traction from 2019–2023 was performed. Patients who presented with a diaphyseal femoral fracture and treated surgically using a post-free traction table were included. Exclusion criteria included inadequate clinical records. Variables including operative time, adequacy of traction, use of “bail-out” perineal post, intra- and post-operative complications, fixation strategy, and fracture union at follow-up were collected for reporting.

Results: Twenty-five traumatic and three pathological femur fractures met inclusion criteria. Adequate traction was reported in all cases using the post-free traction table and no cases reported pudendal nerve palsy or related injuries. Median (confidence interval) operative times including positioning were 2.5 (2.3–3.4) hours for traumatic and 2.7 (1.4–4.3) hours for pathological femur fractures. No complications related to mal-rotation, malunion, or nonunion were documented. One patient developed leg calf swelling postoperatively and one patient developed post-operative left arm neuropraxia.

Conclusions: Post-free traction for the management of paediatric femoral fractures is safe, reliable, and can be considered an excellent alternative to classic perineal post-based traction. No injuries related to perineal pressure were observed.

Keywords: Bone fractures; intramedullary fracture fixation; femur; fracture fixation; paediatric

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab022
Cite this abstract as: MacLeay C, Beaton L, Stoelben K, Smit K, Kerrigan A. AB022. SOH25_AB_128. Novel post-free traction technique provides safe surgical exposure in paediatric and adolescent and femur fracture surgery. Mesentery Peritoneum 2025;9:AB022.

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