Effect of tranexamic acid in treatment of elderly patients with femoral intertrochanteric fracture by proximal femoral nail antirotation

QI Peng; WANG Yucai

doi:10.7619/jcmp.20211121

Journal of Clinical Medicine in Practice > 2021 > 25(12): 54-57. > DOI: 10.7619/jcmp.20211121

QI Peng, WANG Yucai. Effect of tranexamic acid in treatment of elderly patients with femoral intertrochanteric fracture by proximal femoral nail antirotation[J]. Journal of Clinical Medicine in Practice, 2021, 25(12): 54-57. DOI: 10.7619/jcmp.20211121

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Effect of tranexamic acid in treatment of elderly patients with femoral intertrochanteric fracture by proximal femoral nail antirotation

QI Peng,
WANG Yucai^,

Third Department of Orthopedics, Second Affiliated Hospital of Fourth Military Medical University of Chinese People's Liberation Army, Xi'an, Shaanxi, 710038

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Received Date: March 15, 2021
Available Online: July 04, 2021
Published Date: June 27, 2021

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Abstract

Abstract

Objective To investigate the efficacy and safety of tranexamic acid (TXA) in treatment of elderly patients with femoral intertrochanteric fracture by proximal femoral nail antirotation(PFNA).
Methods Seventy elderly patients with intertrochanteric fracture undergoing PFNA surgery were selected as the research subjects. According to whether TXA was used preoperatively, the patients were divided into control group and TXA group, with 35 cases in each group. TXA was not used preoperatively in the control group, while TXA was used preoperatively in the TXA group. The basic clinical data and blood loss of the two groups were analyzed, and the incidence of complications between the two groups was compared through follow-up.
Results The dominant blood loss, intraoperative blood loss, postoperative drainage volume, total blood loss and hidden blood loss in the TXA group were significantly less than those in the control group (P < 0.05). The blood transfusion rate and blood transfusion volume in the TXA group were significantly lower and less than those in the control group (P < 0.05). There were no significant differences in postoperative wound condition and incidence of complications between two groups (P>0.05).
Conclusion In the treatment of intertrochanteric fracture patients with PFNA intramedullary fixation, preoperative intravenous injection of 10 mg/kg TXA can effectively reduce the hidden blood loss and blood transfusion rate in elderly patients, and will not increase the risk of lower extremity deep vein thrombosis and pulmonary embolism, which is safe and effective.

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[1]	张云, 何玉涛. 股骨近端交锁髓内钉-抗螺旋刀片治疗老年性股骨粗隆间粉碎性骨折的效果观察[J]. 实用临床医药杂志, 2020, 24(3): 111-114. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202003032.htm
[2]	张忠岩, 李玉波, 王瑜, 等. 不同方式应用氨甲环酸对PFNA治疗老年不稳定股骨转子间骨折围手术期失血量研究[J]. 创伤外科杂志, 2019, 21(2): 134-137. doi: 10.3969/j.issn.1009-4237.2019.02.013
[3]	TIAN S W, SHEN Z Y, LIU Y, et al. The effect of tranexamic acid on hidden bleeding in older intertrochanteric fracture patients treated with PFNA[J]. Injury, 2018, 49(3): 680-684. doi: 10.1016/j.injury.2018.01.026
[4]	雷金来, 张斌飞, 庄岩, 等. 氨甲环酸减少股骨粗隆间骨折PFNA内固定手术隐性失血的随机对照试验[J]. 中国骨与关节损伤杂志, 2018, 33(12): 1244-1246. doi: 10.7531/j.issn.1672-9935.2018.12.004
[5]	BATíBAY S G, TVRKMEN Í, DUMAN S, et al. Is tranexamic acid safe and reliable during tibial intramedullary nailing[J]. Turkish J Trauma Emerg Surg: TJTES, 2018, 24(6): 575-580. http://www.researchgate.net/publication/342305515_Is_tranexamic_acid_safe_and_reliable_during_tibial_intramedullary_nailing
[6]	XING F, CHEN W, LONG C, et al. Postoperative outcomes of tranexamic acid use in geriatric trauma patients treated with proximal femoral intramedullary nails: a systematic review and meta-analysis[J]. Orthop Traumatol Surg Res, 2020, 106(1): 117-126. doi: 10.1016/j.otsr.2019.10.015
[7]	HUANG F, WU D, MA G W, et al. The use of tranexamic acid to reduce blood loss and transfusion in major orthopedic surgery: a meta-analysis[J]. J Surg Res, 2014, 186(1): 318-327. doi: 10.1016/j.jss.2013.08.020
[8]	LI Z J, FU X, XING D, et al. Is tranexamic acid effective and safe in spinal surgery A meta-analysis of randomized controlled trials[J]. Eur Spine J, 2013, 22(9): 1950-1957. doi: 10.1007/s00586-013-2774-9
[9]	CHEUNG C L, ANG S B, CHADHA M, et al. An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study[J]. Osteoporos Sarcopenia, 2018, 4(1): 16-21. doi: 10.1016/j.afos.2018.03.003
[10]	ZHANG H, XU Z W, ZHOU A G, et al. Efficacy of Kirschner-wires and tension band in hip arthroplasty for aged patients with unstable intertrochanteric osteoporotic fracture: a 2-to-11-year follow-up[J]. Medicine (Baltimore), 2017, 96(1): e5614. doi: 10.1097/MD.0000000000005614
[11]	ZHANG K R, ZHANG S, YANG J, et al. Proximal femoral nail vs. dynamic hip screw in treatment of intertrochanteric fractures: a meta-analysis[J]. Med Sci Monit, 2014, 20: 1628-1633. doi: 10.12659/MSM.890962
[12]	ZHAO P, LIAN X, DOU X F, et al. Intertrochanteric hip fracture surgery in Chinese: risk factors for predicting mortality[J]. Int J Clin Exp Med, 2015, 8(2): 2789-2793. http://www.ncbi.nlm.nih.gov/pubmed/25932236
[13]	MA K L, WANG X, LUAN F J, et al. Proximal femoral nails antirotation, Gamma nails, and dynamic hip screws for fixation of intertrochanteric fractures of femur: a meta-analysis[J]. Orthop Traumatol Surg Res, 2014, 100(8): 859-866. doi: 10.1016/j.otsr.2014.07.023
[14]	SEHAT K R, EVANS R, NEWMAN J H. How much blood is really lost in total knee arthroplasty Correct blood loss management should take hidden loss into account[J]. Knee, 2000, 7(3): 151-155. doi: 10.1016/S0968-0160(00)00047-8
[15]	WANG J, WEI J, WANG M Y. The risk factors of perioperative hemoglobin and hematocrit drop after intramedullary nailing treatment for intertrochanteric fracture patients[J]. J Orthop Sci, 2015, 20(1): 163-167. doi: 10.1007/s00776-014-0667-3
[16]	张东方, 郑稼. 氨甲环酸对股骨头坏死全髋关节置换术后血栓形成及炎症状况的影响[J]. 实用临床医药杂志, 2019, 23(6): 100-102, 106. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL201906027.htm
[17]	ZHANG P, BAI J, HE J, et al. A systematic review of tranexamic acid usage in patients undergoing femoral fracture surgery[J]. Clin Interv Aging, 2018, 13: 1579-1591. doi: 10.2147/CIA.S163950
[18]	王志猛, 路遥, 王谦, 等. 探讨氨甲环酸在老年股骨转子间骨折围手术期应用安全性及有效性分析[J]. 中国骨与关节杂志, 2020, 9(3): 180-185. doi: 10.3969/j.issn.2095-252X.2020.03.005
[19]	刘春光, 宋朋飞, 李兴华. 应用氨甲环酸对股骨近端防旋髓内钉治疗股骨粗隆间骨折患者围手术期隐性失血的临床研究[J]. 中华实验外科杂志, 2020, 37(2): 366-368. doi: 10.3760/cma.j.issn.1001-9030.2020.02.049
[20]	LUO X P, HUANG H Q, TANG X. Efficacy and safety of tranexamic acid for reducing blood loss in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery: a meta-analysis of randomized controlled trials[J]. Acta Orthop Traumatol Turc, 2020, 54(1): 4-14. doi: 10.5152/j.aott.2020.01.88

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