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Li H.-F.,Xining Municipal First Peoples Hospital | Li E.-H.,Xining Municipal First Peoples Hospital | Yan F.-H.,Xining Municipal First Peoples Hospital | Zhao P.,Xining Municipal First Peoples Hospital | Ma J.-J.,Xining Municipal First Peoples Hospital
Chinese Journal of Tissue Engineering Research | Year: 2014

Background: Intertrochanteric fracture refers to the fracture occurred outside hip capsule line to the region below the lesser trochanter, frequently in elder patients. At present, the main therapeutic manner of intertrochanteric fractures includes intramedullary fixation and extramedullary fixation. Objective: To compare hidden blood loss in patients with elderly intertrochanteric fractures after intramedullary and extramedullary fixation, and to explore the related influential factors for perioperative blood loss. Methods: We retrospectively analyzed 298 patients aged > 65 years with intertrochanteric fractures, including 138 males and 160 females. 153 cases underwent intramedullary fixation (81 cases of proximal femoral nail anti-rotation, and 72 cases of Gamma nail). 145 cases received extramedullary fixation. According to Gross equation, perioperative pre-fixation hidden blood loss, post-fixation hidden blood loss, total hidden blood loss, total blood loss and total hidden blood loss proportion were calculated in patients with hip fracture. Perioperative blood loss was compared after intramedullary fixation and extramedullary fixation for intertrochanteric fractures. The effects of gender, operation time, injuries, surgical interval, diabetes and hypertension on above indexes were analyzed. Results And Conclusion: Post-fixation hidden blood loss, total hidden blood loss and total hidden blood loss proportion were significantly higher in the Gamma nail group and proximal femoral nail anti-rotation group than those in the dynamic hip screw group (P < 0.05). Dominant blood loss was significantly less in the Gamma nail group and proximal femoral nail anti-rotation group than those in the dynamic hip screw group (P < 0.05). No significant difference in hidden blood loss and total blood loss was detected before fixation in the three groups. Pre-fixation hidden blood loss was significantly lower in the group whose time from injury to surgery was < 48 hours compared with > 48 hours group (P < 0.05). Post-fixation hidden blood loss and total hidden blood loss were significantly greater in the diabetes group than those in the non-diabetes group (P < 0.05). Post-fixation hidden blood loss and total hidden blood loss were significantly higher in the hypertension group than those in the non-hypertension group (P < 0.05). These data indicated that fixation mode, the time between injury and surgery, hypertension and diabetes are major influential factors for perioperative hidden blood loss in patients with elderly intertrochanteric fractures. We should pay attention to perioperative hidden blood loss in elderly intertrochanteric fracture patients combined with hypertension and diabetes. © 2014, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved. Source

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