Study on application of tranexamic acid in perioperative period of intertrochanter fracture of femur / 中国生化药物杂志

Objective To evaluate the application of tranexamic acid in perioperative period of intertrochanter fracture of femur.Methods 46 cases of patients with intertrochanter fracture of femur were randomLy divided into the control group and treatment group,23 cases in each group.All patients underwent partial hip replacement,10min before operation,the control group was given 0.9％sodium chloride injection100mL,intravenous drip; the experimental group was treated with tranexamic acid injection 10mg/kg,soluble in 100mL 0.9％sodium chloride injection,intravenous drip;Before and after operation,compared between the two groups of patients with blood t hematocrit(HCT),hemoglobin(Hb)levels,volume of blood loss,volume of blood transfusion and incidence of postoperative complications.Results After operation,compared with the control group,the serum levels of HCT、Hb were higher in the experimental group(P<0.05).The total blood loss,hidden blood loss,intraoperative blood loss,postoperative drainage volume and blood transfusion volume were lower in the experimental group(P<0.05).There was no significant difference in the incidence of complications between the 2 groups.Conclusion The tranexamic acid can significantly reduce the volume of blood loss and volume of blood transfusion in perioperative period of patients with intertrochanter fracture of femur,and do not increase the incidence of postoperative complications of thrombosis,and have high security.

Different methods treatment for intertrochanter fracture of femur / 国际外科学杂志

Objective Probe into different method safe and effective fixation method,clinical result and cliniical to indications of different treatments in intertrochanter fracture of femur in the old elderly.Methods Adopting the femur near end dissecting type to lock the stencil plate fixation 14 of 58 cases of old intertrochanter fracture of femur separately.the hip screw of motive force(DHS) fixation was used in 24,femur near end stencil plate fixation in 20,and the blood loss,operation time,ossicle split off situation and fracture heal time were compared among the three groups.Sanders grade results and complications were followed up.Results Postoperative follow up Was done in all patients,from 8 months to 3 years,averaged 1.5 years.three groups of skill type fine rate of the three groups being 92.9%,92%,90%respectively.Conclusions Different methods showed good clinical results in treating the old intertrochanter fracture of femur,each having its indications.Operation should be done should follow based on fracture type,age,physique factors and patient's osteoporosis intensity,choosing the best healing solution by characteristics of intermal flxation while each combining.The hook board(ALHP)is suitable for old patients with serious osteoporosis,DHS for Evans Ⅰ,Ⅱ types and some Evans Ⅲ type,and femur near end dissecting type stencil plate for Ⅳ and Ⅴ types fractures.

The Complication in the Treatment Modality of Intertrochanteric Fracture of Femur / 대한정형외과학회잡지

Intertrochanteric fractures of femur were increasing in their incidence in morden life. The compression hip screw and Ender nail are popular treatment modalities of the interochanteric fracture of femur. We had tried to clarify the complications of intertrochanteric fracture according to the treatment modality-compression hip screw and Ender nail. We obtained the results as followings with the patients who had intertrochanteric fracture of femur which were managed by compression hip screw (56 cases) and Ender nail (22 cases) through the period of March 1987 to June 1993. The summary of the results; 1. Mechanical complications were developed in 9 patients(16%), 9 complications in the group with compression hip screw and 7 patients(32%), 12 complications in Ender nail. 2. Local complications were developed in 4 patients(7%) in compression hip screw and 10 patients (46%) in Ender nail and the most common local complication was the knee joint pain(7 patients; 32%). 3. Statistically, more significant decrease of neck-shaft angle was shown with group using Ender nail for unstable fracture than stable fracture group and compression hip screw group. 4. The degree of shortening was incrased in group with Ender nail than in group with compression hip screw, but there was no statistical significance. 5. The grade of osteoporosis was not related to the change of neck-shaft angle and shortening and also to the development of mechanical complication. According to the above results, compression hip screw was a more stable fixation device than Ender nail in the unstable intertrochanteric fracutre.