Effects of topical tranexamic acid during open reduction and internal fixation of acetabular fractures: A retrospective study

Abstract

Objective The aim of this study was to assess the effect of topical tranexamic acid on blood loss and transfusion rates in acetabular fracture surgery. Methods The medical records of 61 patients who underwent open reduction and internal fixation for acetabular fracture between 2012 and 2015 were retrospectively reviewed. The patients were divided into two groups: Group I consisted of 31 patients (19 men and 12 women, mean age: 52 ± 19 years) who received intraoperatively a topical tranexamic acid solution of 3 g and Group 2 consisted of 30 control patients (17 men and 13 women, mean age: 48 ± 24 years) who received only 0.9% saline solution. The groups were compared based on their intraoperative blood loss, Postoperative drain output at 24 and 48 h, and postoperative hemoglobin levels, and transfusion rates. Results The mean intraoperative blood loss was 410 ± 100 ml in Group 1, compared to 570 ml ± 160 ml of the control group ( p < 0.05). The postoperative drain output after 24 h was 210 ± 70 ml in Group 1 compared to 330 ± 90 ml of the control group ( p < 0.05). The drain output at 48 h was (50 ± 20 ml) in group 1 compared to 90 ± 40 ml of the control group ( p < 0.05). The transfusion rate was significantly low group 1 (42%) than the control group (97%). Hemoglobin drop was again significantly less in tranexamic acid group (2.1 ± 1.1) than the control group (3.2 ± 1.3). The nadir postoperative hemoglobin was higher in the Group 1 (10.4 ± 1.5) than the control group (9.2 ± 1.3). Conclusion Topical administration of tranexamic acid reduces intraoperative and postoperative blood loss in acetabular fracture surgery, decreasing transfusion rates. Level of Evidence Level III, Therapeutic Study.

Effect and safety of topical application of tranexamic acid to reduce perioperative blood loss in elderly patients with intertrochanteric fracture undergoing PFNA

“…We confirmed a obvious reduction in IBL (28%, from 168 reduce to 121 mL). We found the similar approach was used recently in bleeding control of acetabular fractures and it was confirmed to reduce IBL effectively [23].…”

Intravenous administration of tranexamic acid to reduce blood loss during perioperative period in acetabular fracture surgery

“…Andersson et al [8] found that the half-life of aminocycline is approximately 3 h. Accordingly, in this study, we repeated the treatment, and the second and third intravenous infusions of TXA in the multiple treatment group were administered at intervals of 3 h, which can further reduce intraoperative and postoperative bleeding. It has been reported in the literature that the use of TXA in THA can reduce perioperative blood loss and hemoglobin loss in patients, and repeated application of TXA can further reduce perioperative blood loss and hemoglobin loss [17].…”

Rare injury - acetabular fracture combined with ipsilateral intertrochanteric fracture: treatment and outcome in patients with at least 6 years of follow-up

“…For acetabular fractures, surgical treatment is not always necessary [24][25][26][27] because in some cases, fractures are considered stable without displacement, and the fracture has little in uence on the weight-bearing function of the hip joint [28][29][30], such as a small fracture fragment (no more than 1/3 of the area of the posterior wall) without displacement on the posterior wall. If the fracture is considered unstable with displacement greater than 2 mm, surgical treatment should be performed to achieve anatomical reduction to avoid the potential incidence of posttraumatic arthritis [31][32][33]. However, in some situations in which the fracture is comminuted and cannot be anatomically reduced, the fracture fragments are resected to avoid the formation of intra-articular free bodies [34][35][36].…”