Perioperative Blood Loss in Intramedullary Hip Screw for Intertrochanteric Fracture: Analysis of Risk Factors

PURPOSE: We compared visible blood loss and calculated blood loss after intramedullary fixation in intertrochanteric fracture, and evaluated correlation between blood loss and its risk factors. MATERIALS AND METHODS: A total of 256 patients who underwent closed reduction and intramedullary fixation in femoral intertrochanteric fracture between 2004 and 2013 were enrolled in this study. The total blood loss was calculated using the formula reported by Mercuiali and Brecher. We analyzed several factors, including fracture pattern (according to Evans classification), gender, age, body mass index (BMI), anesthesia method, cardiovascular and cerebrovascular disease, preoperative anemia, American Society of Anesthesiologists (ASA) score and use of antithrombotic agents. RESULTS: Total calculated blood loss (2,100+/-1,632 ml) differed significantly from visible blood loss (564+/-319 ml). In addition, the blood loss of unstable fracture patient was 2,496+/-1,395 ml and multivariate analysis showed a significant relationship between blood loss and fracture pattern (p<0.01). However, other factors showed no statistically significant difference. CONCLUSION: Total calculated blood loss was much greater than visible blood loss. Patients with unstable intertrochanteric fracture should be treated with care in order to reduce blood loss.

The Epidemiology and Importance of Osteoporotic Spinal Compression Fracture in South Korea

STUDY DESIGN: Review of the literature on the epidemiology and importance of osteoporotic spinal fractures. OBJECTIVES: To determine the epidemiology and importance of osteoporotic spinal fractures. SUMMARY OF LITERATURE REVIEW: Osteoporotic spinal fractures have been increasing in recent years. MATERIALS AND METHODS: Review of the literature. RESULTS: Osteoporotic spinal fractures can lead to a reduced quality of life and reduced life expectancy with increasing morbidity. They can also be a major cause of additional spinal fractures or secondary fractures. CONCLUSIONS: In an aging society, osteoporotic spinal fractures are considered a social problem. Preventive care should be emphasized.

Regional Bone Loss as a Risk Factor for Distal Radius Fracture in Women under 60 Years Old / 대한골다공증학회지

OBJECTIVES: Some studies have suggested that lumbar spine and hip bone mineral density (BMD) are not associated with distal radius fractures (DRF), and a few studies have investigated regional BMDs at the fracture site, not just the lumbar or hip. We correlated distal radius BMD with DRF in postmenopausal women or =50 years old with DRF were enrolled in the fracture group, and 72 women without fractures were included as a control group. We measured distal radius BMD in the distal radius contralateral to the fractured bone in the fracture group and that of the lumbar body 5 days after the trauma. BMDs at the distal radius of each group were compared in three age groups (50~59, 60~69, and > or =70 years). Age- and site-specific BMDs were analyzed in each group. RESULTS: No significant differences in the rate of osteoporosis at the distal radius or lumbar spine were observed in patients > or =60 years old. However, BMD and T-score values of the distal radius in female patients were lower than those in controls <60 years old. BMD and T-score values of the distal radius were lower than those of the lumbar spine in the fracture group <60 years old. BMD of the distal radius also carried a higher relative risk. CONCLUSIONS: Low BMD of the distal radius was an indicator of regional BMD and could be a sensitive risk factor for DRF in women <60 years.