Abstract
Introduction
Open reduction and internal fixation of acetabular fracture is associated with significant
blood loss. Although Tranexamic acid (TXA) infusion effectively reduces perioperative
blood loss and transfusion requirements in elective orthopedic surgery, its efficacy
in major orthopedic trauma surgery is controversial.
Material and methods
Sixty-three patients undergoing open reduction and internal fixation of acetabular
fracture were randomized into either TXA (n = 36) or placebo (n = 27) group. TXA group received a bolus dose of TXA (10 mg/kg) 15 min prior to incision,
followed by another similar dose after 3 h of surgery. The placebo group received
the same volume of normal saline similarly. All patients were operated on by a single
pelviacetabular surgeon with a uniform perioperative protocol. The intraoperative
blood loss, drain output, the number of blood transfusions, postoperative hemoglobin
(Hb) drop, and hematocrit (Hct) drop were calculated.
Results
Both groups were similar in relation to age, sex, BMI, preoperative Hb, the timing
of surgery, fracture pattern, operative time, and surgical approaches. The mean postoperative
Hb was 10.35 ± 1.36 gm% in TXA group and 9.74 ± 1.98 gm% in placebo group (p-value
0.158). There were no differences in intraoperative blood loss (438.11 ml vs. 442.81,
p=.947), drain output (131.94 ml vs. 129.63, p=.870), and blood transfusion (8 patients vs. five patients, p=.719) between the groups. The drop in Hb and Hct in the postoperative period was
also statistically not significant between the groups.
Conclusion
There is no significant reduction in blood loss and blood transfusion with the use
of intravenous Tranexamic acid in open reduction and internal fixation of acetabular
fractures.
Keywords
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Article info
Publication history
Published online: August 17, 2022
Accepted:
August 15,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
