International Research Journal of Public and Environmental Health
Vol.4 (11),pp. 283-288, December 2017
Available online at https://www.journalissues.org/IRJPEH/
Article 17/ID/JPRH060/ 06 pages
Author(s) retain the copyright of this article. Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution License 4.0 International License.
Original Research Article
Hidden blood loss between PCCP and PFNA in elderly femoral intertrochanteric fracture
Tao Ding*1, Huilin Yang2, James S. Harrop3, Xiaofeng Gu1, Dehong Feng1,Yafeng Zhang4,Fan Zhang5 and Yuntao Xue1
1Department of Orthopaedics,Wuxi People ’s Hospital, Nanjing Medical University, Wuxi City, Jiangsu Province, China.
2Department of Orthopedic Surgery,The First Affiliated Hospital of Soochow University,Suzhou, Jiangsu, China.
3Departments of Neurological and Orthopedic Surgery, Thomas Jefferson University Hospital,909 Walnut Street Philadelphia, PA 19107,USA.
4Department of Orthopaedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine,
Wuxi, Jiangsu, China.
5Department of Orthopaedics, Zhouzhi people’s hospital, Shanxi, China.
*Corresponding Author Email: drdingtao(at)163.com
To compare perioperative hidden blood loss in the treatment of femoral intertrochanteric fractures with percutaneous compression plate (PCCP) and proximal femoral nail anti-rotation (PFNA) in elderly patients, and analyse its influencing factors in order to provide the necessary data support for clinical perioperative treatment, and choice of appropriate internal fixation method. Retrospective analyses was carried out on data obtained from 158 patients with intertrochanteric fracture treated with PCCP or PFNA from January 2010 to May 2017. Data were obtained from variables such as age, gender, height, weight, operative bleeding and postoperative drainage, operation time, etc. Upon blood routine examination before and after surgery (RBC, Hb and Hct), total and hidden blood losses were calculated using Gross equations. A comparative analysis was carried out on the differences in hidden blood loss, postoperative complications and prognosis between PCCP and PFNA.Visible blood loss was higher in PCCP than in PFNA, but total and hidden blood losses were significantly lower in PFNA(P<0.05). Within the two groups, hidden blood loss in elderly patients was significantly higher (P<0.05). Start time of weight-bearing of PCCP group was significantly longer than of PFNA group (P<0.05), but incidences of complications of important organs and perioperative mortality in PCCP group were significantly lower than those of PFNA group (P<0.05). There were no significant differences in operation time, infection of incision, failure of internal fixation, fracture healing time, or Harris function score of half year after operation between the two groups (P<0.05). There is serious hidden blood loss before and after operation in elderly patients with femoral intertrochanteric fractures, of which intramedullary fixation is higher. Intramedullary fixation causes more severe complications of important organs than extramedullary fixation.
Key words: Percutaneous compression plate, proximal femoral anti-rotation nail, femoral intertrochanteric fractures, hidden blood loss.