Use of Tranexamic Acid in Dynamic Hip Screw Plate Fixation for Trochanteric Fractures

Purpose To evaluate perioperative blood loss and blood transfusion requirement in patients who underwent dynamic hip screw plate fixation for a stable trochanteric fracture with or without preoperative intravenous tranexamic acid (TXA). Methods 49 men and 11 women (mean age, 56.5 years) who underwen...

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Main Authors: Ranjit Kumar Baruah, Pranab Jyoti Borah, Russel Haque
Format: Article
Language:English
Published: SAGE Publishing 2016-12-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/1602400322
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author Ranjit Kumar Baruah
Pranab Jyoti Borah
Russel Haque
author_facet Ranjit Kumar Baruah
Pranab Jyoti Borah
Russel Haque
author_sort Ranjit Kumar Baruah
collection DOAJ
description Purpose To evaluate perioperative blood loss and blood transfusion requirement in patients who underwent dynamic hip screw plate fixation for a stable trochanteric fracture with or without preoperative intravenous tranexamic acid (TXA). Methods 49 men and 11 women (mean age, 56.5 years) who underwent open reduction and internal fixation with a dynamic hip screw plate for a stable trochanteric fracture by a single surgeon were equally randomised to receive either a single dose of intravenous TXA (15 mg/kg) 15 minutes prior to surgery or an equal volume of normal saline by slow infusion. Intra- and post-operative blood loss and the need for blood transfusion were assessed, as was any thromboembolic adverse event. Results The TXA and control groups were comparable in terms of age, gender, body mass index, blood pressure, pulse rate, time from injury to surgery, operating time, and preoperative haematological data. Blood loss was lower in the TXA than control group intraoperatively (320.3 vs. 403.33 ml, p<0.001), during 0 to 24 hours (61.67 vs. 186.67 ml, p<0.001), and during 24 to 48 hours (27 vs. 86.67 ml, p<0.001), as well as the total volume (408.97 vs. 676.67 ml, p<0.001). Respectively for the TXA and control groups, 27 and 30 required 28 and 41 units of blood intra-operatively (p<0.001), and 6 and 15 required 6 and 15 units of blood postoperatively (p=0.014). No patient had any thromboembolic adverse event. Conclusion TXA is safe and effective in reducing blood loss in dynamic hip screw plate fixation for stable trochanteric fractures.
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spelling doaj.art-820e007fc0c6455ca6b1c9dd4fd4dbd92022-12-22T00:15:47ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902016-12-012410.1177/1602400322Use of Tranexamic Acid in Dynamic Hip Screw Plate Fixation for Trochanteric FracturesRanjit Kumar BaruahPranab Jyoti BorahRussel HaquePurpose To evaluate perioperative blood loss and blood transfusion requirement in patients who underwent dynamic hip screw plate fixation for a stable trochanteric fracture with or without preoperative intravenous tranexamic acid (TXA). Methods 49 men and 11 women (mean age, 56.5 years) who underwent open reduction and internal fixation with a dynamic hip screw plate for a stable trochanteric fracture by a single surgeon were equally randomised to receive either a single dose of intravenous TXA (15 mg/kg) 15 minutes prior to surgery or an equal volume of normal saline by slow infusion. Intra- and post-operative blood loss and the need for blood transfusion were assessed, as was any thromboembolic adverse event. Results The TXA and control groups were comparable in terms of age, gender, body mass index, blood pressure, pulse rate, time from injury to surgery, operating time, and preoperative haematological data. Blood loss was lower in the TXA than control group intraoperatively (320.3 vs. 403.33 ml, p<0.001), during 0 to 24 hours (61.67 vs. 186.67 ml, p<0.001), and during 24 to 48 hours (27 vs. 86.67 ml, p<0.001), as well as the total volume (408.97 vs. 676.67 ml, p<0.001). Respectively for the TXA and control groups, 27 and 30 required 28 and 41 units of blood intra-operatively (p<0.001), and 6 and 15 required 6 and 15 units of blood postoperatively (p=0.014). No patient had any thromboembolic adverse event. Conclusion TXA is safe and effective in reducing blood loss in dynamic hip screw plate fixation for stable trochanteric fractures.https://doi.org/10.1177/1602400322
spellingShingle Ranjit Kumar Baruah
Pranab Jyoti Borah
Russel Haque
Use of Tranexamic Acid in Dynamic Hip Screw Plate Fixation for Trochanteric Fractures
Journal of Orthopaedic Surgery
title Use of Tranexamic Acid in Dynamic Hip Screw Plate Fixation for Trochanteric Fractures
title_full Use of Tranexamic Acid in Dynamic Hip Screw Plate Fixation for Trochanteric Fractures
title_fullStr Use of Tranexamic Acid in Dynamic Hip Screw Plate Fixation for Trochanteric Fractures
title_full_unstemmed Use of Tranexamic Acid in Dynamic Hip Screw Plate Fixation for Trochanteric Fractures
title_short Use of Tranexamic Acid in Dynamic Hip Screw Plate Fixation for Trochanteric Fractures
title_sort use of tranexamic acid in dynamic hip screw plate fixation for trochanteric fractures
url https://doi.org/10.1177/1602400322
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AT russelhaque useoftranexamicacidindynamichipscrewplatefixationfortrochantericfractures