• Jinlai Lei, Binfei Zhang, Yuxuan Cong, Yan Zhuang, Xing Wei, Yahui Fu, Wei Wei, Pengfei Wang, Shiming Wen, Hai Huang, Hu Wang, Shuang Han, Shuguang Liu, and Kun Zhang.
• Department of Orthopaedic Trauma, Xi'an Honghui Hospital, Xi'an Jiaotong University Health Science Center, No 555, Youyi East Road, Xi'an, Shaanxi Province, China.
• J Orthop Surg Res. 2017 Aug 15; 12 (1): 124.

BackgroundHidden blood loss is a major concern for patients undergoing hip surgery for intertrochanteric fracture. The objective of this study was to investigate whether tranexamic acid (TXA) could reduce postoperative hidden blood loss in patients undergoing hip surgery for intertrochanteric fracture.MethodsA total of 77 patients with intertrochanteric fracture were enrolled in this randomized controlled study. Patients received either 200 mL (1 g) of TXA (n = 37) or normal-saline (NS) (n = 40) i.v. before hip surgery using proximal femoral nail anti-rotation (PFNA). Hemoglobin and hematocrit levels were measured preoperatively and postoperatively at day 1 and 3. Visible and hidden blood loss volumes were calculated at postoperative day 3.ResultsOn postoperative day 3, the transfusion rate was significantly lower in the TXA group compared to the NS group, although mean hemoglobin and hematocrit levels were not significantly different between the two groups. However, the estimated hidden blood loss volume (210.09 ± 202.14 mL vs. 359.35 ± 290.12 mL; P < 0.05) and total blood loss volume (279.35 ± 209.11 mL vs. 417.89 ± 289.56 mL; P < 0.05) were significantly less in the TXA group compared to the NS group, respectively.ConclusionTXA significantly reduced postoperative hidden blood loss in patients with intertrochanteric fracture who underwent PFNA. (Registration number: ChiCTR-INR-16008134).

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