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The visible and hidden blood loss of Asia proximal femoral nail anti-rotation and dynamic hip screw in the treatment of intertrochanteric fractures of elderly high- risk patients: a retrospective comparative study with a minimum 3 years of follow-up.

Yu W, Zhang X, Wu R, Zhu X, Hu J, Xu Y, Yi J, Liu Y - BMC Musculoskelet Disord (2016)

Bottom Line: The clinical data from Jan 2005 to Apr 2015 of 186 patients with PFNA-II and 177 patients with DHS were analyzed retrospectively.However, the post-operative hidden blood loss and the total blood loss in the PFNA-II group were larger than in the DHS group (p < 0.01).This study demonstrated that with PFNA-II and DHS, much post-operative hidden blood loss exists in the treatment of intertrochanteric fractures in elderly high-risk patients and DHS is more favourable than PFNA-II in terms of post-operative hidden blood loss.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, The First Affiliated Hospital of Sun Yat-sen University, Huangpu East Road No. 183, Huangpu District, Guangzhou City, Guangdong Province, 510700, China.

ABSTRACT

Background: The purpose of this study was to evaluate whether PFNA-II (Asia proximal femoral nail anti-rotation) and DHS (dynamic hip screw) carry substantial post-operative hidden blood loss and to compare PFNA-II with DHS in terms of post-operative hidden blood loss in elderly high-risk patients with intertrochanteric femur fractures(IFFs).

Methods: The clinical data from Jan 2005 to Apr 2015 of 186 patients with PFNA-II and 177 patients with DHS were analyzed retrospectively. Indexes including pre- and post-operative blood routine, intra- and post-operative blood loss and blood transfusion situation were analyzed. The situation of perioperative blood loss (visible and hidden) was assessed.

Results: The intra-operative blood loss in the PFNA-II group was 34.7 ± 2.5 ml, the post-operative visible blood loss was 54.7 ± 2.5 ml, and the hidden blood loss was 277.2 ± 7.6 ml. In the DHS group, the intra-operative blood loss was 102.0 ± 7.0 ml, the post-operative visible blood loss was 78.8 ± 4.7 ml, and the hidden blood loss was 139.3 ± 9.6 ml. The intra-operative blood loss and the post-operative visible blood loss in the PFNA-II group were significantly less than in the DHS group (p < 0.01). However, the post-operative hidden blood loss and the total blood loss in the PFNA-II group were larger than in the DHS group (p < 0.01).

Conclusion: This study demonstrated that with PFNA-II and DHS, much post-operative hidden blood loss exists in the treatment of intertrochanteric fractures in elderly high-risk patients and DHS is more favourable than PFNA-II in terms of post-operative hidden blood loss.

No MeSH data available.


Related in: MedlinePlus

Flow diagram demonstrating methods for identification of studies to assess the treatment of intertrochanteric femur fractures in the elderly using either the Asia proximal femoral nail anti-rotation (PFNA-II) or the dynamic hip screw (DHS) systems, and reasons for exclusion
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Fig1: Flow diagram demonstrating methods for identification of studies to assess the treatment of intertrochanteric femur fractures in the elderly using either the Asia proximal femoral nail anti-rotation (PFNA-II) or the dynamic hip screw (DHS) systems, and reasons for exclusion

Mentions: Based on these criteria, 922 patients were excluded. In those patients, 105 patients were excluded because of the use of antiplatelet drug (clopidogrel or aspirin). Another 228 patients refused to participate, leaving 441 patients eligible for the study. During the follow-up, 73 patients refused to continue participating in the study. Two patients died from cardiac arrest, and 3 patients died of drowning, cerebrovascular disease, and an automobile accident. Consequently, 363 patients (375 primary operations, PFNA-II, n = 186; DHS, n = 177) were involved in the final evaluation (Table 2, Fig. 1). Osteoporosis was defined as bone mineral density(BMD)T-score value ≤ −2.5 at the femoral neck.Table 2


The visible and hidden blood loss of Asia proximal femoral nail anti-rotation and dynamic hip screw in the treatment of intertrochanteric fractures of elderly high- risk patients: a retrospective comparative study with a minimum 3 years of follow-up.

Yu W, Zhang X, Wu R, Zhu X, Hu J, Xu Y, Yi J, Liu Y - BMC Musculoskelet Disord (2016)

Flow diagram demonstrating methods for identification of studies to assess the treatment of intertrochanteric femur fractures in the elderly using either the Asia proximal femoral nail anti-rotation (PFNA-II) or the dynamic hip screw (DHS) systems, and reasons for exclusion
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940845&req=5

Fig1: Flow diagram demonstrating methods for identification of studies to assess the treatment of intertrochanteric femur fractures in the elderly using either the Asia proximal femoral nail anti-rotation (PFNA-II) or the dynamic hip screw (DHS) systems, and reasons for exclusion
Mentions: Based on these criteria, 922 patients were excluded. In those patients, 105 patients were excluded because of the use of antiplatelet drug (clopidogrel or aspirin). Another 228 patients refused to participate, leaving 441 patients eligible for the study. During the follow-up, 73 patients refused to continue participating in the study. Two patients died from cardiac arrest, and 3 patients died of drowning, cerebrovascular disease, and an automobile accident. Consequently, 363 patients (375 primary operations, PFNA-II, n = 186; DHS, n = 177) were involved in the final evaluation (Table 2, Fig. 1). Osteoporosis was defined as bone mineral density(BMD)T-score value ≤ −2.5 at the femoral neck.Table 2

Bottom Line: The clinical data from Jan 2005 to Apr 2015 of 186 patients with PFNA-II and 177 patients with DHS were analyzed retrospectively.However, the post-operative hidden blood loss and the total blood loss in the PFNA-II group were larger than in the DHS group (p < 0.01).This study demonstrated that with PFNA-II and DHS, much post-operative hidden blood loss exists in the treatment of intertrochanteric fractures in elderly high-risk patients and DHS is more favourable than PFNA-II in terms of post-operative hidden blood loss.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, The First Affiliated Hospital of Sun Yat-sen University, Huangpu East Road No. 183, Huangpu District, Guangzhou City, Guangdong Province, 510700, China.

ABSTRACT

Background: The purpose of this study was to evaluate whether PFNA-II (Asia proximal femoral nail anti-rotation) and DHS (dynamic hip screw) carry substantial post-operative hidden blood loss and to compare PFNA-II with DHS in terms of post-operative hidden blood loss in elderly high-risk patients with intertrochanteric femur fractures(IFFs).

Methods: The clinical data from Jan 2005 to Apr 2015 of 186 patients with PFNA-II and 177 patients with DHS were analyzed retrospectively. Indexes including pre- and post-operative blood routine, intra- and post-operative blood loss and blood transfusion situation were analyzed. The situation of perioperative blood loss (visible and hidden) was assessed.

Results: The intra-operative blood loss in the PFNA-II group was 34.7 ± 2.5 ml, the post-operative visible blood loss was 54.7 ± 2.5 ml, and the hidden blood loss was 277.2 ± 7.6 ml. In the DHS group, the intra-operative blood loss was 102.0 ± 7.0 ml, the post-operative visible blood loss was 78.8 ± 4.7 ml, and the hidden blood loss was 139.3 ± 9.6 ml. The intra-operative blood loss and the post-operative visible blood loss in the PFNA-II group were significantly less than in the DHS group (p < 0.01). However, the post-operative hidden blood loss and the total blood loss in the PFNA-II group were larger than in the DHS group (p < 0.01).

Conclusion: This study demonstrated that with PFNA-II and DHS, much post-operative hidden blood loss exists in the treatment of intertrochanteric fractures in elderly high-risk patients and DHS is more favourable than PFNA-II in terms of post-operative hidden blood loss.

No MeSH data available.


Related in: MedlinePlus