The Efficiency of Skeletal Traction with TrakPak®: A Retrospective Cohort Analysis

Introduction Skeletal traction is commonly used for acute management of lower extremity and pelvic injuries but is associated with inefficiencies that can prolong emergency department stays and delay definitive care. The TrakPak® system was designed to improve efficiency by streamlining equipment acquisition, eliminating the need for specialized traction beds, and reducing costs. This study aimed to evaluate the clinical impact of TrakPak® adoption on time to traction, surgery, and MRI and overall hospital length of stay. Materials and Methods We conducted a retrospective cohort study of adult trauma patients undergoing skeletal traction at a single Level 1 trauma center between May 2023 and May 2025. Patients were divided into pre-TrakPak® (n=64) and post-TrakPak® (n=101) groups. Time from admission to traction, surgery, MRI, and hospital discharge were collected, along with injury severity scores (ISS, NISS, TRISS). Comparisons were made using t-tests or Mann-Whitney U tests depending on data distribution. Sub-analyses at 1000-, 600-, and 360-minute cutoffs were performed to assess the impact of outliers. Results A total of 165 patients were analyzed. There were no significant differences in ISS, NISS, or TRISS between cohorts. Median time to traction was 3.80 hours pre-TrakPak® and 4.23 hours post-TrakPak® (p=0.59). Time to surgery was significantly longer after TrakPak® adoption (16.02 vs. 21.43 hours, p=0.031) but remained within 24 hours. Time to MRI (35.80 vs. 57.38 hours, p=0.174) and hospital length of stay (7 vs. 7 days, p=0.535) were not significantly different. Results were consistent across the cutoff analyses. Conclusion Adoption of the TrakPak® system did not significantly improve the measured variables in this single-center study. However, TrakPak® remains advantageous due to its user-friendliness, portability, elimination of traction bed requirements, and cost savings. Future multi-center studies are warranted to better evaluate its potential efficiency benefits. Level of Evidence: Level III, retrospective comparative study