• Injury · Aug 2021

    The efficacy of intravenous tranexamic acid administration at induction in definitive hip fracture surgery: Is there a role?

    • S Kanthasamy, B Guhan, D Chakravarty, and Martyn J Parker.
    • Surgical Teaching Fellow, Peterborough City Hospital, United Kingdom. Electronic address: Senthooran.kanthasamy@nhs.net.
    • Injury. 2021 Aug 1; 52 (8): 2361-2366.

    AbstractTranexamic acid (TXA) is a cheap and powerful drug that has several uses in surgery and is well established in elective orthopaedic surgery. At present, limited small studies have looked into its role in the acute hip fracture. Transfusion in the geriatric population presents risks and increased costs to healthcare systems around the world. Our retrospective study looks at the role of TXA administration at induction for both intracapsular fracture requiring hemiarthroplasty and our preferred method of fixation of extracapsular fracture by intramedullary nail (IM nail). We show a statistically significant reduction in the number of patients requiring transfusion as well as mean haemoglobin (Hb) drop in those undergoing hemiarthroplasty. This was not replicated in those undergoing IM nail fixation. Both groups showed no increase in 1-year mortality or thromboembolic events following TXA administration. These results support the use of TXA for hemiarthroplasty for intracapsular hip fractures over the age of 60.Copyright © 2021 Elsevier Ltd. All rights reserved.

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