{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T01:36:49Z","timestamp":1771637809662,"version":"3.50.1"},"reference-count":22,"publisher":"International College of Surgeons","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>This is a prospective study to evaluate the efficacy of the Perkins traction in the treatment of adult femoral shaft fractures from October 1, 2007, to the present at the Black Lion Hospital in Addis Ababa University Hospital in Ethiopia. All femur fractures admitted to the hospital were reviewed and evaluated for treatment. Black Lion Hospital (Tikur Anbessa) is the university hospital in Addis Ababa and the highest tertiary teaching hospital in a country of 85 million inhabitants. A 67-bed orthopedic department offers the main ground for teaching to the undergraduate medical students. The hospital is also the pivotal center for the formation of the orthopedic residents. Patients from different parts of the country are referred to this institution for orthopedic care. A total of 68 adult (older than 16\u00a0years) patients with 69 femoral shaft fractures were considered for treatment during the study period. Consent was obtained and prospective treatment initiated. A standard Perkins traction was applied by an orthopedic team composed of consultants, orthopedic residents, physical therapists, and nurses. A protocol was developed for patients undergoing such traction. The physiotherapists will supervise all individual or group therapy sessions. Progressive knee range of motion to facilitate quadriceps and hamstring muscle strengthening exercises were implemented four times a day and recorded. Demographic information, fracture patterns, duration of traction, thigh circumference leg length discrepancy, and pin sites were routinely monitored and charted. Data were computerized and analyzed weekly, and appropriate adjustments were made accordingly. Clinical evidence of a competent callus and confirmation by radiographic studies will influence the cessation of traction to allow gait training with toe-touch crutch ambulation. Progress will be monitored during the following outpatient visits in the fracture clinic. A total of 68 consecutive patients with 69 femoral shaft fractures were treated with the Perkins traction. There were 60 men (88.2%) and only 8 women (11.8%), for a ratio of 8 men to 1 woman. The age of the cohort patient varied between 18 and 28\u00a0years.<\/jats:p>\n        <jats:p>The mechanisms of injury for most of the fractures were motor vehicle accidents, resulting in an isolated femoral shaft fracture in 49.2% of the patients. Half of the fractures were by means of closed injury (n \u200a=\u200a 44; 64.7%). One patient with a bilateral femoral shaft fracture was also added to the study. The right side was more often involved, with 41 fractures (60%), than the left, with 28 fractures (40%). Most of the fractures involved the proximal third of the femur (n \u200a=\u200a 34; 50%), but the most common fracture pattern was transverse (n \u200a=\u200a 29; 42.6%), followed by a comminuted pattern (n \u200a=\u200a 18; 26.5%). Three segmental fractures were also encountered.<\/jats:p>\n        <jats:p>The mean hospital stay was 45\u00a0days (33 patients; 48.5%), with the length of time in traction varying from 30 to 40\u00a0days. Only 2 patients remained in traction for a period of 60\u00a0days. At the end of the traction period, 8 patients (11.8%) showed a decrease in the quadriceps mass, and 7 patients (10.3%) showed stiffness of the knee with a range of motion limited to 0\u00b0 to 90\u00b0. Most patients were discharged after about 8\u00a0months of treatment. One patient suffered a nonunion, and one was malunited. Superficial pin care infections were noted in 8 patients (11.8%) and treated appropriately.<\/jats:p>\n        <jats:p>The conservative treatment of 69 femoral shaft fractures using the Perkins traction at Black Lion University Hospital in Addis Ababa, Ethiopia, has been proven to be a safe and effective method. It should be encouraged in countries like ours where it is a luxury to have a C-Arm in the operating room and where the hardware often is not available to perform a stable stabilization of the long bone fractures.<\/jats:p>","DOI":"10.9738\/cc48.1","type":"journal-article","created":{"date-parts":[[2012,10,25]],"date-time":"2012-10-25T15:57:41Z","timestamp":1351180661000},"page":"78-85","source":"Crossref","is-referenced-by-count":17,"title":["Treatment of Adult Femoral Shaft Fractures Using the Perkins Traction at Addis Ababa Tikur Anbessa University Hospital: The Ethiopian Experience"],"prefix":"10.9738","volume":"97","author":[{"given":"Bahiru","family":"Bezabeh","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Addis Ababa Tikur Anbessa University Hospital, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biruk L","family":"Wamisho","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Addis Ababa Tikur Anbessa University Hospital, Addis Ababa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxime JM","family":"Coles","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery & Traumatology, Coffeyville Regional Medical Center, Coffeyville, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"10","key":"i0020-8868-97-1-78-Bucholz1","series-title":"J Bone Jt Surg Am","first-page":"1561","article-title":"Fractures of the shaft of the femur.","volume":"73-A","author":"Bucholz, RW","year":"1991","unstructured":"Bucholz, RW and JonesA. Fractures of the shaft of the femur.J Bone Jt Surg Am1991. 73-A (10):1561\u20131566."},{"issue":"2","key":"i0020-8868-97-1-78-Fakhry1","series-title":"J Trauma","first-page":"255","article-title":"Incidence, management, and outcome of femoral shaft fracture: a statewide population-based analysis of 2805 adult patients in a rural state.","volume":"37","author":"Fakhry, SM","year":"1994","unstructured":"Fakhry, SM, RutledgeR, DahnersLE, and KesslerD. Incidence, management, and outcome of femoral shaft fracture: a statewide population-based analysis of 2805 adult patients in a rural state.J Trauma1994. 37 (2):255\u2013261."},{"issue":"6","key":"i0020-8868-97-1-78-Gillquist1","series-title":"Acta Chir Scand","first-page":"515","article-title":"Fracture of the femur diaphysis: traction or nailing?","volume":"137","author":"Gillquist, J","year":"1971","unstructured":"Gillquist, J, LiljedahlSO, and RiegerA. Fracture of the femur diaphysis: traction or nailing?Acta Chir Scand1971. 137 (6):515\u2013520."},{"issue":"suppl 8","key":"i0020-8868-97-1-78-Pape1","series-title":"J Orthop Trauma","first-page":"S13","article-title":"Changes in the management of femoral shaft fractures in polytrauma patients: from early care to damage control orthopedic surgery.","volume":"18","author":"Pape, HC","year":"2004","unstructured":"Pape, HC, HildebrandF, PertschyS, ZelleB, et al. Changes in the management of femoral shaft fractures in polytrauma patients: from early care to damage control orthopedic surgery.J Orthop Trauma2004. 18 (suppl 8):S13\u2013S23."},{"issue":"8","key":"i0020-8868-97-1-78-Peltier1","series-title":"J Bone Jt Surg Am","first-page":"1603","article-title":"A brief history of traction.","volume":"50-A","author":"Peltier, LF","year":"1968","unstructured":"Peltier, LF\n          . 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Rest and movement.J Bone Jt Surg Br1953. 35-B (4):521\u2013540."},{"key":"i0020-8868-97-1-78-Perkins2","series-title":"Fractures and Dislocations","author":"Perkins, G","year":"1958","unstructured":"Perkins, G\n          . Fractures and Dislocations. London, EnglandAthlone Press. 1958."},{"issue":"2","key":"i0020-8868-97-1-78-Kevau1","series-title":"PNG Med J","first-page":"143","article-title":"Conservative management of femoral shaft fractures.","volume":"39","author":"Kevau, I","year":"1996","unstructured":"Kevau, I and WattersDA. Conservative management of femoral shaft fractures.PNG Med J1996. 39 (2):143\u2013151."},{"issue":"102","key":"i0020-8868-97-1-78-Mays1","series-title":"Clin Orthop Relat Res","first-page":"144","article-title":"Skeletal traction methods.","author":"Mays, J","year":"1974","unstructured":"Mays, J and NeufeldAJ. Skeletal traction methods.Clin Orthop Relat Res1974. (102):144\u2013151."},{"issue":"5","key":"i0020-8868-97-1-78-Gates1","series-title":"J Bone Jt Surg","first-page":"750","article-title":"Hinged cast and roller traction for fractured femur: a system of treatment for the third world.","volume":"67-B","author":"Gates, DJ","year":"1985","unstructured":"Gates, DJ, AlmsM, and CruzMM. Hinged cast and roller traction for fractured femur: a system of treatment for the third world.J Bone Jt Surg1985. 67-B (5):750\u2013756."},{"issue":"2","key":"i0020-8868-97-1-78-Ahmed1","series-title":"East Afr Med J","first-page":"43","article-title":"Orthopedic and major limb trauma at the Tikur Anbessa University Hospital.","volume":"10","author":"Ahmed, E","year":"2005","unstructured":"Ahmed, E and ChakaT. Orthopedic and major limb trauma at the Tikur Anbessa University Hospital.East Afr Med J2005. 10 (2):43\u201350."},{"issue":"3","key":"i0020-8868-97-1-78-Moulton1","series-title":"Injury","first-page":"244","article-title":"Closed femoral fractures: why not simple traction?","volume":"13","author":"Moulton, A","year":"1981","unstructured":"Moulton, A, AgunwaWC, and HopkinsJS. Closed femoral fractures: why not simple traction?Injury1981. 13 (3):244\u2013248."},{"issue":"10","key":"i0020-8868-97-1-78-Mandrella1","series-title":"Unfallchirug","first-page":"923","article-title":"The conservative treatment of femur fractures by Perkins' traction.","volume":"105","author":"Mandrella, B","year":"2002","unstructured":"Mandrella, B\n          . The conservative treatment of femur fractures by Perkins' traction.Unfallchirug2002. 105 (10):923\u2013931."},{"issue":"19","key":"i0020-8868-97-1-78-Procter1","series-title":"S Afr Med J","first-page":"598","article-title":"The functional treatment of fractures of the femur.","volume":"36","author":"Procter, DSC","year":"1962","unstructured":"Procter, DSC\n          . The functional treatment of fractures of the femur.S Afr Med J1962. 36 (19):598\u2013602."},{"issue":"16","key":"i0020-8868-97-1-78-Usdin1","series-title":"S Afr Med J","first-page":"480","article-title":"The treatment of fractures of the femur by Perkins' traction.","volume":"43","author":"Usdin, J","year":"1969","unstructured":"Usdin, J\n          . The treatment of fractures of the femur by Perkins' traction.S Afr Med J1969. 43 (16):480\u2013482."},{"issue":"5","key":"i0020-8868-97-1-78-Gosselin1","series-title":"Int Orthop","first-page":"697","article-title":"Perkins traction for adult femoral shaft fractures: a report on 53 patients in Sierra Leone.","volume":"31","author":"Gosselin, R","year":"2007","unstructured":"Gosselin, R and LavalyD. Perkins traction for adult femoral shaft fractures: a report on 53 patients in Sierra Leone.Int Orthop2007. 31 (5):697\u2013702."},{"issue":"1","key":"i0020-8868-97-1-78-Biruk1","series-title":"ECASJ","first-page":"41","article-title":"Permanent civilian musculoskeletal disability following injury-17\u00a0year trends.","volume":"11","author":"Biruk, LW","year":"2006","unstructured":"Biruk, LW\n          . Permanent civilian musculoskeletal disability following injury-17\u00a0year trends.ECASJ2006. 11 (1):41\u201348."},{"issue":"1","key":"i0020-8868-97-1-78-Admasie1","series-title":"ECAJS","first-page":"88","article-title":"Radiological and clinical details of major adult limb fractures in a teaching hospital, AAU, Ethiopia.","volume":"14","author":"Admasie, Y","year":"1999","unstructured":"Admasie, Y, TekleY, and WamishoBL. Radiological and clinical details of major adult limb fractures in a teaching hospital, AAU, Ethiopia.ECAJS1999. 14 (1):88\u201397."}],"container-title":["International Surgery"],"original-title":[],"link":[{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/97\/1\/article-p78.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/international-surgery\/article-pdf\/97\/1\/78\/2213300\/cc48_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/97\/1\/article-p78.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/international-surgery.kglmeridian.com\/downloadpdf\/journals\/insu\/97\/1\/article-p78.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T19:02:52Z","timestamp":1751482972000},"score":1,"resource":{"primary":{"URL":"https:\/\/international-surgery.kglmeridian.com\/view\/journals\/insu\/97\/1\/article-p78.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1]]},"references-count":22,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.9738\/cc48.1","relation":{},"ISSN":["2520-2456","0020-8868"],"issn-type":[{"value":"2520-2456","type":"electronic"},{"value":"0020-8868","type":"print"}],"subject":[],"published":{"date-parts":[[2012,1]]}}}