Clinical comparison of blood loss of peri-operation between femoral neck fracture and intertrochanteric fracture in elderly patients

doi:10.3877/cma.j.issn.2096-0263.2020.04.004

Abstract

Abstract:

Objective

To provide scientific basis for perioperative blood management of elderly patients with femoral neck fracture and intertrochanteric fracture by comparing their perioperative blood loss.

Methods

All of 69 elderly patients with hip fracture caused by low energy injury admitted to Orthopaedic Department of the first Affiliated Hospital of University of Science and Technology of China from July 2018 to April 2020 were included in this study. According to the type of fracture, patients divided into femoral neck fracture group and femoral intertrochanteric fracture group. Age, sex, anatomical site of fracture and comorbidity were compared between the two groups. The hidden blood loss, dominant blood loss and total blood loss were calculated and compared between the two groups.

Results

The mean age of patients in the femoral neck fracture group was (78±8) years old (10 Male, 35 Female), and that of patients with intertrochanteric fracture was (75±10) years old (12 Male, 12 Female). There were statistically significant differences in the pre-operative hidden blood loss [(238.33±97.82) vs (344.80±130.01)ml, P<0.05)], peri-operative Hidden blood loss [(314.46±130.30) vs (459.73±173.34)ml, P<0.05)], dominant blood loss [(77.78±27.29)ml vs (160.42±51.03)ml, P<0.05)] and total blood loss [(392.24±133.62)ml vs (620.15±171.11)ml, P<0.05)] between the two groups. The intertrochanteric fracture group were significantly higher than that of the femoral neck fracture group. The intertrochanteric fracture group (hemi-hip replacement and PFNA internal fixation) had more dominant blood loss, post-operative hidden blood loss, peri-operative hidden blood loss and total blood loss than the femoral neck fracture group (total hip replacement and hemi-hip replacement) (all P<0.05). However, there was no significant statistical difference between the two groups in different surgical procedures (all P>0.05).

Conclusions

The elderly patients with intertrochanteric fracture have more perioperative hidden blood loss and dominant blood loss than those with femoral neck fracture. In clinical diagnosis and treatment. We should pay more attention to perioperative blood management of elderly patients with intertrochanteric fracture.

Key words: Aged, Femoral neck fractures, Femoral intertrochanteric fractures, Blood loss, Hidden blood loss

Zusheng Hu, Xianling Liu, Lei Wang, Wen Duan, Ce Fang, Jixue Zhang. Clinical comparison of blood loss of peri-operation between femoral neck fracture and intertrochanteric fracture in elderly patients[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2020, 06(04): 204-210.

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References 30

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组别	例数	性别（例）		骨折部位（例）		年龄（岁，±s）	BMI（kg/m²，±s）
组别	例数	男性	女性	左侧	右侧	年龄（岁，±s）	BMI（kg/m²，±s）
股骨颈骨折组	45	10	35	24	21	78±8	22.90±1.46
股骨转子间骨折组	24	12	12	13	11	75±10	22.66±1.59
统计值		χ²=5.561		χ²=0.061		t=1.483	t=0.627
P值		0.118		0.804		0.143	0.533

组别	例数	性别（例）		骨折部位（例）		年龄（岁，±s）	BMI（kg/m²，±s）
组别	例数	男性	女性	左侧	右侧	年龄（岁，±s）	BMI（kg/m²，±s）
股骨颈骨折组	45	10	35	24	21	78±8	22.90±1.46
股骨转子间骨折组	24	12	12	13	11	75±10	22.66±1.59
统计值		χ²=5.561		χ²=0.061		t=1.483	t=0.627
P值		0.118		0.804		0.143	0.533

组别	例数	高血压	2-型糖尿病	冠心病	脑梗死后遗症
股骨颈骨折组	45	18	4	2	12
股骨转子间骨折组	24	7	6	1	4
χ²值		1.389	3.278	0.879	0.003
P值		0.239	0.070	0.349	0.957

组别	例数	高血压	2-型糖尿病	冠心病	脑梗死后遗症
股骨颈骨折组	45	18	4	2	12
股骨转子间骨折组	24	7	6	1	4
χ²值		1.389	3.278	0.879	0.003
P值		0.239	0.070	0.349	0.957

组别	例数	显性失血量	术前隐性失血量	围手术期隐性失血量	总失血量
股骨颈骨折组	45	77.78±27.29	238.33±97.82	314.46±130.30	392.24±133.62
股骨转子间骨折组	24	160.42±51.03	344.80±130.01	459.73±173.34	620.15±171.11
t值		-7.390	-3.831	-3.923	-6.110
P值		<0.01	<0.01	<0.01	<0.01

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