Hidden Blood Loss After Intertrochanteric Femoral Fracture Treated With PFNA, Gamma And DHS

ObjectiveAnalyze the hidden blood loss(HBL) in perioperative period of femoral intertrochanteric fractures treated with proximal femoral nail anti-rotation(PFNA), Gamma nail or dynamic hips crew(DHS), and explore the factors which may affect the blood loss. In order to enhance the iinical realization of hidden blood loss and give evidences for clinical managements.MethodsWe retrospectively studied66patients treated with PFNA(n=26), Gamma nail(n=20) and DHS(n=20). The HBLs were calculated and compared on the base of height, weight, the change of hemoglobin. At the same time, evaluate the factors of gender, age, obesity and transfusion on the hidden blood loss.ResultsThe mean total blood loss volume was767.10ml, and the hidden blood loss volume was705.18ml(91%) in the PFNA group; The mean total blood loss volume was836.20ml, and the hidden blood loss volume was758.70ml(90%) in the Gamma nail group; The mean total blood loss volume was596.35ml, and the hidden blood loss volume was509.70ml(82%) in the DHS group; The diffence of hidden blood loss was significant between DHS group and PFNA group or Gamma nail group(P<0.05), while the hidden blood loss volumes in PFNA group or Gamma nail group had no diffences(P>0.05); The younger group(under the age of80) obviously had a less hidden blood loss than the older group(over80years of age)(P<0.05); The transfusion group also had a different hidden blood loss with the no transfusion group(P<0.01); However, the gender and BMI both had no effect on hidden blood loss.ConclusionThere were much hidden blood loss in all PFNA, Gamma nail and DHS groups after operations for femoral intertrochanteric fractures. Compared with DHS group, PFNA and Gamma nail groups had a much more hidden blood loss, and the advanced age was the high risk factor. So, we should pay more attention to old patients after operation for intertrochanteric fractures. Measure the hemoglobin and supplement the blood volume to decrease the complications and help the patients recover from perioperation.