Abstract
Purpose
We evaluated the bleeding volume after surgery for trochanteric fractures of the femur in patients treated with antiplatelet agents according to surgical timing.
Materials and Methods
We selected 20 patients who had trochanteric fractures of the femur treated with antiplatelet agents from January 2009 to June 2010. Group I included 9 patients who discontinued antiplatelet medication and had delayed operations at an average of 6.5 days and Group II included 11 patients who underwent early operations within 24 hours. Group I included 2 males and 7 females; their average age was 77.8 years (range 59~86). Group II included 4 males and 7 females, with an average age of 73.5 years (range 61~84). We compared the two groups' volume of intraoperative bleeding, the preoperative and postoperative hemoglobin levels and the volume of postoperative transfusion. The Mann-Whitney U test was used for statistical analysis.
Results
The volume of intraoperative bleeding was 88 ml in group I and 106 ml in group II (p>0.01). The difference in the hemoglobin was a decrease of 2.4 mg% in group I and a decrease of 2.2 mg% in group II (p>0.01). The volume of postoperative transfusion was 0.6 pints in group I and 1 pint in group II (p>0.01).
Figures and Tables
References
1. Al-Ani AN, Samuelsson B, Tidermark J, et al. Early operation on patients with a hip fracture improved the ability to return to independent living. A prospective study of 850 patients. J Bone Joint Surg Am. 2008. 90:1436–1442.
2. American Society of Anesthesiologists. New classification of physical status. Anesthesiology. 1963. 24:111.
3. Cummings SR, Rubin SM, Black D, et al. The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen. Clin Orthop Relat Res. 1990. (252):163–166.
4. Davis FM, Woolner DF, Frampton C, et al. Prospective, multi-centre trial of mortality following general or spinal anaesthesia for hip fracture surgery in the elderly. Br J Anaesth. 1987. 59:1080–1088.
5. Epstein RS. Hip fractures in the elderly. How to reduce morbidity and mortality. Postgrad Med. 1988. 84:254–257.
6. Ha YC, Kim SR, Koo KH, et al. An epidemiological study of hip fracture in Jeju island, Korea. J Korean Orthop Assoc. 2004. 39:131–136.
7. Iorio R, Healy WL, Appleby D, Milligan J, Dube M. Displaced femoral neck fractures in the elderly: disposition and outcome after 3- to 6-year follow-up evaluation. J Arthroplasty. 2004. 19:175–179.
8. Melton LJ 3rd. Hip fractures: a worldwide problem today and tomorrow. Bone. 1993. 14:Suppl 1. S1–S8.
9. Moran CG, Wenn RT, Sikand M, Taylor AM. Early mortality after hip fracture: is delay before surgery important? J Bone Joint Surg Am. 2005. 87:483–489.
10. Nydick JA, Farrell ED, Marcantonio AJ, Marburger R, Ostrum RF. The use of clopidogrel (Plavix) in patients undergoing nonelective orthopaedic surgery. J Orthop Trauma. 2010. 24:383–386.
11. Rowe SM, Yoon TR, Ryang DH. An epidemiological study of hip fracture in Honam, Korea. Int Orthop. 1993. 17:139–143.
12. US FDA Official Information. Cilostazolrug, Triflusal Page [Internet]. Available from: http://www.drugs.com/pro/cilostazol.html, http://www.drugs.com/international/triflusal.html.
13. Valentin N, Lomholt B, Jensen JS, Hejgaard N, Kreiner S. Spinal or general anaesthesia for surgery of the fractured hip? A prospective study of mortality in 578 patients. Br J Anaesth. 1986. 58:284–291.
14. Weber AA, Braun M, Hohlfeld T, Schwippert B, Tschöpe D, Schrör K. Recovery of platelet function after discontinuation of clopidogrel treatment in healthy volunteers. Br J Clin Pharmacol. 2001. 52:333–336.
15. Zuckerman JD, Sakales SR, Fabian DR, Frankel VH. The challenge of geriatric hip fractures. Bull N Y Acad Med. 1990. 66:255–265.