• Yijie Yin, Jiabao Jiang, Chang Zou, Shenbo Huang, Shuai He, Guy Romeo Kenmegne, You Yu, and Yue Fang.
• Department of Orthopedics Surgery, Orthopedic Research Institute, West China Hospital of Sichuan University, Chengdu, China.
• Medicine (Baltimore). 2024 Sep 20; 103 (38): e39703e39703.

BackgroundTranexamic acid (TXA) is commonly used to reduce perioperative bleeding in various surgeries, including acetabular and pelvic fractures treated with open reduction and internal fixation (ORIF). However, research on TXA's effectiveness and safety in this context is conflicting. To address this, we conducted a systematic review and meta-analysis on TXA's efficacy and safety in patients with acetabular and pelvic fractures undergoing ORIF.MethodsWe systematically searched Cochrane, PubMed, and EMBASE databases until August 30, 2023. Our evaluation of TXA focused on 6 domains: estimated blood loss (EBL), blood transfusion units, transfusion rates, thromboembolic events, other complications, and surgery duration. Data from these studies were analyzed using RevMan Manager 5.4.ResultsThis study included 4 randomized controlled trials with 179 patients with acetabular and pelvic fractures treated with TXA. The analysis showed that TXA did not significantly reduce EBL, packed red blood cell transfusion units, blood transfusion rates, or surgery duration. There was no significant difference in thromboembolic events or other postoperative complications, like surgical wound issues, pneumonia, heterotopic ossification, and sciatic nerve injuries, between the TXA and control groups.ConclusionTXA did not demonstrate a significant benefit in reducing perioperative bleeding or complications in patients treated with ORIF for acetabular and pelvic fractures. The utilization of TXA in such clinical scenarios remains a topic necessitating further rigorous investigation to delineate its role in this clinical setting.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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