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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

Box plots showing the characteristics of its statistical distribution. DHS, dynamic hip screw; PFNA-II, Asia proximal femoral nail anti-rotation
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Fig2: Box plots showing the characteristics of its statistical distribution. DHS, dynamic hip screw; PFNA-II, Asia proximal femoral nail anti-rotation

Mentions: The details of the hidden and visible blood loss with PFNA-II and DHS are shown in Table 4. Box plots show the distribution characteristic of measured data (Fig. 2). The frequency distribution of the total blood loss measurements was that its concentration appeared as a clearly centralized distribution in both groups: in Group PFNA-II, most of the values are approximately 368 ml, whereas in Group DHS, the values were approximately 320 ml (Fig. 3). As for hidden blood loss measurements, the concentration also appeared as a clearly centralized distribution in both groups: in Group PFNA-II, most of the values were approximately 277 ml, in Group DHS, approximately 139 ml (Fig. 4). A characteristics of the statistical distribution of visible blood loss revealed that in Group PFNA-II, most of the values were approximately 89 ml, whereas in Group DHS, the values were approximately 180 ml (Fig. 5). Variable mean differences between two groups are shown in Fig. 6. In Group PFNA-II, the mean operation time was 35.5 ± 1.4 min. The mean intra-operation blood loss was 34.7 ± 2.5 ml, without blood transfusion during operation. Due to a significant decrease in blood red protein (<8 g/L) on the 2nd-4th post-operative days, 36 patients were provided with a blood transfusion, which averaged 300 ± 15 ml in volume. The visible blood loss post-operation for 186 patients was an average of 89.4 ± 4.0 ml; the hidden blood loss was an average of 277.2 ± 7.6 ml. There were significant differences in the hidden blood loss, the post-operative visible blood loss and the total blood loss between genders in Group PFNA-II (p < 0.01). The mean follow-up period was 39 months (range, 37–42 months) for two groups.Table 4


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)

Box plots showing the characteristics of its statistical distribution. DHS, dynamic hip screw; PFNA-II, Asia proximal femoral nail anti-rotation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Box plots showing the characteristics of its statistical distribution. DHS, dynamic hip screw; PFNA-II, Asia proximal femoral nail anti-rotation
Mentions: The details of the hidden and visible blood loss with PFNA-II and DHS are shown in Table 4. Box plots show the distribution characteristic of measured data (Fig. 2). The frequency distribution of the total blood loss measurements was that its concentration appeared as a clearly centralized distribution in both groups: in Group PFNA-II, most of the values are approximately 368 ml, whereas in Group DHS, the values were approximately 320 ml (Fig. 3). As for hidden blood loss measurements, the concentration also appeared as a clearly centralized distribution in both groups: in Group PFNA-II, most of the values were approximately 277 ml, in Group DHS, approximately 139 ml (Fig. 4). A characteristics of the statistical distribution of visible blood loss revealed that in Group PFNA-II, most of the values were approximately 89 ml, whereas in Group DHS, the values were approximately 180 ml (Fig. 5). Variable mean differences between two groups are shown in Fig. 6. In Group PFNA-II, the mean operation time was 35.5 ± 1.4 min. The mean intra-operation blood loss was 34.7 ± 2.5 ml, without blood transfusion during operation. Due to a significant decrease in blood red protein (<8 g/L) on the 2nd-4th post-operative days, 36 patients were provided with a blood transfusion, which averaged 300 ± 15 ml in volume. The visible blood loss post-operation for 186 patients was an average of 89.4 ± 4.0 ml; the hidden blood loss was an average of 277.2 ± 7.6 ml. There were significant differences in the hidden blood loss, the post-operative visible blood loss and the total blood loss between genders in Group PFNA-II (p < 0.01). The mean follow-up period was 39 months (range, 37–42 months) for two groups.Table 4

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