The perioperative hidden blood loss in intertrochanteric fractures: a comparative study
10.3760/cma.j.issn.0253-2352.2012.07.008
- VernacularTitle:股骨转子间骨折围手术期隐性失血的比较研究
- Author:
Gang FENG
;
Zhijun PAN
;
Youchen YE
- Publication Type:Journal Article
- Keywords:
Hip fractures;
Intraoperative period;
Blood loss,surgical
- From:
Chinese Journal of Orthopaedics
2012;32(7):648-653
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the perioperative hidden blood loss (HBL) associated with different fixation methods for intertrochanteric fracture.Methods We retrospectively studied 128 patients with 31-A1 and 31-A2 intertrochanteric fractures which underwent internal fixation with dynamic hip screw (DHS,n=35),short reconstruction intramedullary hip screw (IMHS,n=55) or percutaneous compression plate (PCCP,n=38) from January 2008 to January 2012.The HBL were calculated and compared.Results The mean total hidden blood loss (THBL) was more than 7 times than the mean apparent blood loss (ABL) in all the three groups.For the THBL,there were significant statistical differences among three groups; no difference was found between IMHS and DHS group.For the phasic hidden blood loss (PHBL),there was no difference among the three phase of treatment in DHS group.But in IMHS and PCCP group,there were significant differences between the 4th-5th day and the 1st day,the 2nd-3rd day after operation; no difference was found between the Ist and the 2nd-3rd day.For the ratio of PHBL/THBL there were significant differences between the 4th-5th day and the 1st day,the 2nd-3rd day after operation; but no statistical differences were found between the 1st day and the 2nd-3rd day after operation.Conclusion It can be concluded that HBL after surgery for intertrochanic fractures is much greater than that observed intra-operatively.The IMHS and DHS cause more HBL than PCCP.Frequent post-operative measurements of haemoglobin are necessary,especially the first three days after surgery.