Shufeng Huang#, Minli Wang#, Zheyuan Shen#, Wenlin Hu*
Department of Orthopedics, The First People’s Hospital of Huzhou,First Affiliated Hospital of Huzhou Teachers College,Huzhou, Zhejiang, 313000, PR China
Objective: To investigate the influence of different administration methods of tranexamic acid on blood loss volume and complications in elderly patients with AO2.2~3 intertrochanteric fracture in internal fixation.
Methods: Clinical data of 174 elderly patients with AO2.2~3 intertrochanteric fracture admitted to our hospital from March 2015 to October 2020 were retrospectively analyzed and all patients divided into three groups: Group A (without tranexamic acid, 70 cases), Group B (tranexamic acid injection through medullary cavity, 55 cases) and Group C (intravenous injection of tranexamic acid, 49 cases). The perioperative blood loss volume, postoperative drainage volume, blood transfusion rate, Hb level, HCT level and incidence of thrombosis related complications among the 3 groups were compared.
Results: The perioperative blood loss volume and blood transfusion rate of Group B and Group C were significantly less than those of Group A (P<0.05). There was no significant difference in blood loss volume and postoperative drainage volume among 3 groups (P>0.05). The levels of Hb and Hct of Group B and Group C in 1d, 3d and 5d after operation were significantly higher than those of Group A (P<0.05). Color Doppler ultrasound of lower extremity blood vessels reexamined in 5d and 4w after operation showed that there were 2 cases and 3 cases of intramuscular venous thrombosis in Group A and Group B respectively, with the incidence of 2.86% and 5.45% respectively. No thrombotic com-plications such as deep vein thrombosis, pulmonary embolism, ACS and stroke were found.
Conclusion: Intravenous injection and intramedullary administration of tranexamic acid in the treatment of elderly patients with AO2.2~3 intertrochanteric fracture in internal fixation can effectively decrease the total blood loss volume and hidden blood loss volume in the perioperative period, reduce the blood transfusion rate, without the increase of the risks of thrombosis related complications.
Internal fixation, tranexamic acid, elderly, intertrochanteric fracture, blood loss, complications.