Perioperative factors associated with hidden blood loss in intertrochanteric fracture patients

Liu, Y.; Sun, Yue; Liu, Fan; Hao, Jiheng

doi:10.1007/s12306-016-0447-7

Cited by 26 publications

(34 citation statements)

References 16 publications

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“…The unstable group of ITFs also revealed a greater Hb drop during the perioperative period. The risk factors for greater blood loss and hidden blood loss are age, time interval between injury and surgery, duration of operation, BMI, presence of diabetes mellitus, and the use of anticoagulants [15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Lin

Chien

Hung

et al. 2020

BMC Musculoskelet Disord

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Background: With an increase in the elderly population, the occurrence of hip fractures, femoral neck fractures, and intertrochanteric fractures (ITFs) is also increasing. It is important to establish effective perioperative methods that would help reduce the morbidity and mortality rates associated with ITFs. The purpose of this study was to determine the effects of ITFs according to the AO classification for perioperative hemoglobin drop. Methods: Seventy-six patients with ITFs classified as AO 31-A1 or A2 and fixated with intramedullary nails participated in this retrospective cohort study. Medical records of these patients were retrospectively reviewed from September 2016 to August 2018. The perioperative hemoglobin drop was chosen as the main outcome measure and calculated as the difference between pre-and postoperative hemoglobin levels. Multivariate linear regression analysis was performed and included the following variables: AO classification (A1.1-A2.1 [stable] vs. A2.2-A2.3 [unstable]), time interval between injury and surgery, age, body mass index, and the use of anticoagulants. Results: Among the 76 patients who met the inclusion criteria, a significantly higher hemoglobin drop was observed in the AO 31 A2.2-A2.3 (unstable) group than in the AO 31 A1.1-A2.1 (stable) group (p = 0.04). The multivariate analysis also showed a greater hemoglobin drop in the unstable group (p < 0.05). Conclusions: Patients with unstable ITFs exhibited a greater hemoglobin drop and a hidden blood loss was suspected around the fracture site. We believe that this should be taken into consideration when presurgical blood transfusion is being planned for patients with unstable ITFs, to reduce associated postoperative complications, especially in patients with severe anemia or high risk of mortality.

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Section: Discussionmentioning

confidence: 99%

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Lin

Chien

Hung

et al. 2020

BMC Musculoskelet Disord

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“…Compared with extramedullary xation, intramedullary xation holds the following advantages: the intramedullary xation system belongs to central xation, which is more in line with the biomechanics of the proximal femur and can better perform femoral anatomical reduction, improving the stability of internal xation; the operation is simple and convenient with a short operation time, and the injury of blood vessels and nerves may be greatly avoided [7] [8] [9] ; the surgical incision is small, which protects the blood supply of the fracture end to the greatest extent and is conducive to fracture healing. The postoperative incision healing time is shorter, and the postoperative recovery is faster [10] [11] [12] ; early mobility can greatly reduce the occurrence of postoperative complications, and hip joint functional exercises may be performed more quickly [13] [14] ; effects in long-term operation is reliable, and the failure rate is relatively low with the passage of time [15] [16] [17] .…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Intramedullary Fixation vs. Plate Fixation for Femoral Intertrochanteric Fractures

Zhou¹,

Xia²,

Ma³

et al. 2020

Preprint

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Objective: To compare the clinical efficacy of proximal femoral intramedullary fixation and anatomical locking compression plate in the treatment of femoral intertrochanteric fractures among the elderly. Methods: In this retrospective study, 210 surgically treated patients with intertrochanteric fractures of the femur were analyzed and divided into groups A, B and C according to the surgical approach. Group A had interlocking compression nailing (INTERTAN) done (n=69); group B had γ-III interlocking intramedullary nailing (γ-III) done (n=73); and group C had proximal femoral anatomic locking plate (PFLP) done (n=68). All patients’ data were followed up completely, and their clinical outcomes were observed. Results: Group A and B were found to perform better than group C in operation time, bleeding volume, time of leaving bed, fracture healing time and hospitalization time (P < 0.05). Their respective incidences of postoperative complications were significantly lower than that of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). The Harris scores of groups A and B at 1, 3 and 6 months after operation were significantly higher than those of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). Conclusions: In the treatment of femoral intertrochanteric fractures, intramedullary fixation influences little on blood circulation at the fracture end, accelerates fracture healing, and enhances hip joint function, which assists patients in recovering faster postoperatively. Moreover, it enables them to gain mobility at an early stage and reduces postoperative complications of fractures. Its short-term clinical effects are better than extramedullary fixation, which should be more widely adapted clinically.

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Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Intramedullary Fixation vs. Plate Fixation for Femoral Intertrochanteric Fractures

Zhou

Xia

et al. 2020

Preprint

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Background To compare the clinical efficacy of proximal femoral intramedullary fixation and anatomical locking compression plate in the treatment of femoral intertrochanteric fractures among the elderly. Methods In this retrospective study, 210 surgically treated patients with intertrochanteric fractures of the femur were analyzed and divided into groups A, B and C according to the surgical approach. Group A had interlocking compression nailing (INTERTAN) done (n = 69); group B had γ-III interlocking intramedullary nailing (γ-III) done (n = 73); and group C had proximal femoral anatomic locking plate (PFLP) done (n = 68). All patients’ data were followed up completely, and their clinical outcomes were observed. Results Group A and B were found to perform better than group C in operation time, bleeding volume, time of leaving bed, fracture healing time and hospitalization time (P < 0.05). Their respective incidences of postoperative complications were significantly lower than that of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). The Harris scores of groups A and B at 1, 3 and 6 months after operation were significantly higher than those of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). Conclusions In the treatment of femoral intertrochanteric fractures, intramedullary fixation influences little on blood circulation at the fracture end, accelerates fracture healing, and enhances hip joint function, which assists patients in recovering faster postoperatively. Moreover, it enables them to gain mobility at an early stage and reduces postoperative complications of fractures. Its short-term clinical effects are better than extramedullary fixation, which should be more widely adapted clinically.

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Perioperative factors associated with hidden blood loss in intertrochanteric fracture patients

Cited by 26 publications

References 16 publications

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Clinical Efficacy of Intramedullary Fixation vs. Plate Fixation for Femoral Intertrochanteric Fractures

Clinical Efficacy of Intramedullary Fixation vs. Plate Fixation for Femoral Intertrochanteric Fractures

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