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Comparison of intramedullary and extramedullary fixation of stable intertrochanteric fractures in the elderly: a prospective randomised controlled trial exploring hidden perioperative blood loss

BMC musculoskeletal disorders, 2016-11, Vol.17 (1), p.475-475, Article 475 [Peer Reviewed Journal]

COPYRIGHT 2016 BioMed Central Ltd. ;Copyright BioMed Central 2016 ;The Author(s). 2016 ;ISSN: 1471-2474 ;EISSN: 1471-2474 ;DOI: 10.1186/s12891-016-1333-z ;PMID: 27846888

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Title:
Comparison of intramedullary and extramedullary fixation of stable intertrochanteric fractures in the elderly: a prospective randomised controlled trial exploring hidden perioperative blood loss
Author: Cai, Leyi ; Wang, Te ; Di, Lu ; Hu, Wei ; Wang, Jianshun
Subjects: Aged ; Aged patients ; Aged, 80 and over ; Analysis ; Anemia ; Blood Loss, Surgical - statistics & numerical data ; Blood Transfusion ; Bone Nails ; Bone Screws ; Care and treatment ; Clinical trials ; Complications and side effects ; Female ; Fracture Fixation, Internal - adverse effects ; Fracture Fixation, Internal - instrumentation ; Fracture Fixation, Internal - methods ; Fracture Fixation, Intramedullary - adverse effects ; Fracture Fixation, Intramedullary - instrumentation ; Health aspects ; Hip Fractures - surgery ; Humans ; Internal fixation in fractures ; Male ; Operative Time ; Perioperative Period ; Postoperative Complications - epidemiology ; Prospective Studies ; Recovery of Function ; Retrospective Studies
Is Part Of: BMC musculoskeletal disorders, 2016-11, Vol.17 (1), p.475-475, Article 475
Description: Hip fracture is a severe and common injury that occurs predominantly in the elderly. Blood loss in the perioperative period is associated with a greater risk of dying in anaemic patients. The aim of the study was to explore the best way to treat stable intertrochanteric fractures, taking hidden blood loss into account. This prospective, randomised blinded study included patients aged over 65 years with stable intertrochanteric fractures (Evans grades I and II). The patients were allocated to one of two groups treated via extramedullary or intramedullary fixation. Patient data were retrieved from electronic charts. Functional recovery was evaluated using the Functional Recovery Score of Zuckerman. Postoperative complications were also recorded. The formula of Nadler and Gross was used to calculate blood loss. There were 92 patients in the extramedullary and 106 in the intramedullary group. Age, sex, the cause of injury, the type of fracture, the observed blood loss, functional recovery, time to union, complications, and American Society of Anesthesiologists classification did not differ significantly between the two groups (all p-values > 0.05). The frequencies of lung infection, electrolyte imbalance, and hypoproteinemia differed between groups (all p-values < 0.05). Total and hidden blood loss were higher in the intramedullary group (p = 0.001). Extramedullary (compared with intramedullary) fixation of stable intertrochanteric fractures significantly reduces perioperative blood loss but affords similar functional outcomes and times to union. In view of the morbidity and complications associated with acute anaemia and transfusions, extramedullary fixation may be the optimal choice for treatment of stable fractures, being associated with reduced blood loss. The study was retrospectively registered at the Chinese Clinical Trial Registry, number: ChiCTR-INQ-16009754 , trial registration date: 6th Nov. 2016.
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1471-2474
EISSN: 1471-2474
DOI: 10.1186/s12891-016-1333-z
PMID: 27846888
Source: GFMER Free Medical Journals
MEDLINE
PubMed Central
Springer Nature OA/Free Journals
ROAD: Directory of Open Access Scholarly Resources
ProQuest Central
DOAJ Directory of Open Access Journals

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Comparison of intramedullary and extramedullary fixation of stable intertrochanteric fractures in the elderly: a prospective randomised controlled trial exploring hidden perioperative blood loss

COPYRIGHT 2016 BioMed Central Ltd. ;Copyright BioMed Central 2016 ;The Author(s). 2016 ;ISSN: 1471-2474 ;EISSN: 1471-2474 ;DOI: 10.1186/s12891-016-1333-z ;PMID: 27846888

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