[Blood loss and need for transfusion assessment in open reduction and internal fixation of femoral shaft fractures]

Background and Objective: A high percentage of patients with multiple traumas sustained at least from an orthopedic problem. One of the high frequent lesions was femoral shaft fracture. The aim of this study was to determine the amount of bleeding and the need for blood transfusion in femoral shaft fractures and risk factors

Methods: This descriptive, retrospective study was done on 84 patients with femoral shaft fractures whom were operated in Imam Khomeini Hospital in, Sari, in northern Iran during 2012-15. Age, sex, comorbidities, type of fracture, hospitalization period, pre and post-operative hemoglobin and blood unit's loss were recorded for each patient

Results: In 43 patients [51.19%] plate and in 41 patients [48.80%] intramedullary naling were used for treatment of fractures.13 [15.47%], 33 [39.28%] and 37[44.04%] of patients were received one, two and three blood units, respectively. There was no significant relationship between energy intensity and age. There was significant relationship between the intensity and the type of fracture [P<0.05]. A significant correlation existed between blood unit transfusion with sex, fracture type, hemoglobin before surgery and fracture energy intensity [P<0.05]

Conclusion: Based on the results of this study, it is recommended for hip fracture at least 3 units of blood should be reserved

effect of starting treatment in the prevalence of scaphoid nonunion

Scaphoid fractures are the most common wrist fractures; immobilization of wrist by plaster of Paris is the treatment of choice in persisting fractures of the middle and terminal part of the scaphoid. Many factors are effective on nonunion of scaphoid bone. The purpose of this study was to determine the relation between delay in starting treatment [1 to 3 weeks] with prevalence rate of fracture nonunion. In this study, the result of union in 57 patients with middle part fracture of the scaphoid and 1 to 3 weeks delay in treatment was compared with 60 patients as control who referred for treatment on the first day of fracture. Out of 57 cases under study, in 8 there was nonunion and in the control group, only 2 patients had nonunion, which indicated delay in treatment is significantly effective on nonnunion of scaphoid fractures [p<0.05]. It is recommended that in case of feeling pain and sensitivity on the snuffbox after trauma to wrist even when there is no evidence of fracture line in radiography be considered scaphoid fracture and treatment with plastering be undertaken and delay in starting treatment due to the increase in prevalence rate of scaphoid nonunion