Abstract:
OBJECTIVE:To investigate the efficacy and safety of tranexamic acid (TXA) in the reduction of bleeding and the need for transfusion in elderly intertrochanteric fracture patients. METHODS:A total of 100 patients with intertrochanteric fractures undergoing surgery were enrolled and randomly allocated to the TXA group in which patients (75.10 ± 8.27 years old) were treated with 1 g of TXA, or the control group (77.82 ± 6.42 years old) treated with a placebo. Surgery was performed by two senior orthopaedic surgeons from two institutions. The proximal femoral nail antirotation (PFNA) was conducted using the standard procedure. Three outcome measures, including blood loss, transfusion, and complications, were recorded. Blood loss and transfusion were investigated to assess TXA's effectiveness, while complications were investigated to assess TXA's safety. Statistical indicators for blood loss included total, intraoperative, postoperative, and hidden blood loss volumes, calculated by hemoglobin levels, hematocrit levels, and drainage volume. The number and amount of blood transfusions were recorded. Complications associated with surgery, including deep vein thrombosis, pulmonary embolism, wound hematoma, wound infection, cardiovascular and cerebrovascular accidents, and respiratory infections, were also recorded. RESULTS:All patients were followed up for 1 month after surgery. There were no significant differences in demographic and clinical characteristics between the two groups. The TXA group suffered significantly less total blood loss (563.37 ± 197.51 vs 819.25 ± 273.96 mL, 95% CI: -349.49 to -162.27, P < 0.01), intraoperative blood loss (140.3 ± 80.64 vs 230.5 ± 130.56 mL, 95% CI -132.74 to -47.66, P < 0.01), and hidden blood loss (410.42 ± 178.23 vs 571.19 ± 218.13 mL, 95% CI: -238.85 to -82.69, P < 0.01) than the control group. However, postoperative total blood loss was not significantly different (97.5 ± 20.93 vs 94.7 ± 35.78 mL; P = 0.63). A total of 5 patients from the TXA group and 27 from the control group received packed RBC for postoperative transfusion, but the mean number of transfusion units was not significantly different between groups. Complications including deep vein thrombosis, pulmonary embolism, myocardial infarction, ischemic cerebral infarction, hematoma, and infection were observed in both groups, but no significant differences were found. CONCLUSIONS:In intertrochanteric fracture surgery performed using PFNA, intravenous administration of TXA significantly reduced the risk of intraoperative, total and hidden blood loss, in addition to the need for allogeneic transfusion, without increasing the rate of complications.
journal_name
Orthop Surgjournal_title
Orthopaedic surgeryauthors
Zhou XD,Zhang Y,Jiang LF,Zhang JJ,Zhou D,Wu LD,Huang Y,Xu NWdoi
10.1111/os.12511subject
Has Abstractpub_date
2019-08-01 00:00:00pages
635-642issue
4eissn
1757-7853issn
1757-7861journal_volume
11pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:At present, cephalomedullary nail is the most frequently used implant in the management of intertrochanteric fractures around the world. The implant design and fixation techniques of the cephalomedullary nail have been continuously improved to ensure uncomplicated bone union during the past decade. However, a...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12828
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:We create a new S1 cortical screw trajectory technique using 3D reconstruction and the finite element (FE) method to provide a more reliable theoretical basis for clinical practices and to advance internal fixation technology for treatment of lumbosacral degenerative diseases. METHODS:This retrospective stud...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12624
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:To compare the superior-level facet joint violations (FJV) between robot-assisted (RA) percutaneous pedicle screw placement and conventional open fluoroscopic-guided (FG) pedicle screw placement in a prospective cohort study. METHODS:This was a prospective cohort study without randomization. One-hundred pati...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12534
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To investigate delay in diagnosis by both patients and doctors, and to evaluate its effect on outcomes of high-grade sarcoma of bone in a single-referral oncological center. METHODS:Fifty-four patients with osteosarcoma, 29 with Ewing sarcoma and 19 with chondrosarcoma were enrolled in this retrospective stu...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12239
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy and safety of the postoperative long-term effect of the treatment of single-level cervical spondylosis through anterior cervical discectomy and fusion (ACDF) and artificial cervical disc replacement (ACDR). METHODS:This is a retrospective contrastive study, which was conducted for the...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12634
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To describe the technique of primary repair of medial collateral ligament (MCL) insufficiency using a screw and rectangular spiked washer in a case series of 14 patients. METHODS:Fourteen patients undergoing MCL repair by a screw and rectangular spiked washer during TKA between March 2018 and March 2019 were...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12818
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety and effectiveness of osteotomy adjacent to the articular surface of the metatarsal head combined with basal opening wedge osteotomy for severe hallux valgus. METHODS:The double osteotomy procedure was carried out in 56 patients (72 feet) with severe hallux valgus deformity, with an ave...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12505
更新日期:2019-08-01 00:00:00
abstract::The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of i.v. tranexamic acid (TXA) in simultaneous bilateral total knee arthroplasty (TKA). Potentially relevant published reports were identified from the following electronic databases: Medline, PubMed, Embase, ScienceDirect...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1111/os.12256
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To investigate the utility and medium-term results of a new intra-operative classification system for distal tibiofibular syndesmosis injury in ankle fractures. METHODS:Between January 2010 and January 2015, 116 patients diagnosed with displaced closed Weber B and C ankle fractures were treated in our depart...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12355
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of hip replacement and intramedullary nails for treating unstable intertrochanteric fractures in elderly patients. METHODS:Randomized clinical trials (RCTs) to compare hip replacement with intramedullary nail in the management of elderly patients with unstable intertrochan...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,meta分析
doi:10.1111/os.12532
更新日期:2019-10-01 00:00:00
abstract::Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,评审
doi:10.1111/os.12334
更新日期:2017-05-01 00:00:00
abstract::To observe the morphology character of the anterior epidural space at the L4-5 disc level and to provide an anatomical basis for safely and accurately performing a percutaneous endoscopic lumbar discectomy (PELD). Fifty-five cases with L5 S1 lumbar disc herniation were included in this study, and cases with L4-5 disea...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12325
更新日期:2017-05-01 00:00:00
abstract::In the realm of orthopaedics, the terrible triad of the elbow is infamous, not simply because the prognosis is poor for most patients, but also, maybe to a greater extent, because the unique name of this malady attracts considerable attention and interest in both doctors and patients. The adjective terrible is bestowe...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,评审
doi:10.1111/os.12149
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:We analyzed chondrosarcomas in long bones to assess whether Grade I and II chondrosarcomas should both be grouped as low grade malignant tumors (musculoskeletal Tumor Society Stage I or Stage II), and to explore rational surgical treatment for Grade I and II chondrosarcomas. METHODS:We retrospectively review...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/j.1757-7861.2009.00020.x
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To develop a novel screw positioning method to improve the treatment of unstable thoracolumbar fractures. METHODS:A total of 72 patients with unstable thoracolumbar fractures who were treated with anterior screw-rod interfixation from January 2011 to October 2015 were included in this clinical study. Those p...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12506
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To assess the clinical efficacy of mini-invasive transforaminal lumbar interbody fusion (TLIF) through the Wiltse approach for treating lumbar spondylolytic spondylolisthesis. METHODS:In this retrospective controlled study, 69 cases with lumbar spondylolytic spondylolisthesis treated in Qilu hospital from Ap...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1111/os.12224
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:To investigate the association between the number of metastases to the spine and survival in patients with metastatic spinal cord compression (MSCC), as well as the prognosis difference between patients with solitary spinal metastasis (SSM) and multiple spinal metastases (MSM). METHODS:Three institutional d...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12470
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:Relatively few studies have reported on the morphology of the supracondylar femur, which is a fundamental factor affecting prosthetic reconstruction. The objectives of the present study were to measure the morphological parameters of the supracondylar femur, to classify the supracondylar femur, and to provide...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12443
更新日期:2019-04-01 00:00:00
abstract::Diaphyseal defects in long bones of extremities following segmental resection are very common in the clinic, and reconstruction remains a great challenge. Although there are many treatments for diaphyseal defects at present, reconstruction with an intercalary endoprosthesis may be an optimal method. We demonstrate a s...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12391
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To introduce an iliosacral screw fixation guide and evaluate its efficacy in fixation of sacroiliac joint fracture-dislocations. METHODS:Between January 2011 and May 2011, eight patients (five men, three women) with sacroiliac joint fracture-dislocation underwent percutaneous iliosacral screw fixation with t...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/j.1757-7861.2011.00162.x
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To present the use of an intermediate dorsal neurocutaneous flap for the reconstruction of defects on the distal foot. METHODS:From September 2016 to October 2018, five patients (mean age at operation 33.8 years; range, 7-70 years; female/male = 2/3) with skin defects on one of their feet caused by road-traf...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12623
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The present retrospective study was performed to assess the anatomical features of the pedicle in isthmic spondylolisthesis and to correlate this with degree of slip. METHODS:Twenty-six patients with isthmic spondylolytic spondylolisthesis were studied. Relevant patient variables, length, width, height of th...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12173
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of timing of surgery on clinical results and perioperative complications in pediatric patients with Gartland III type supracondylar humeral fractures without neurovascular compromise. METHODS:Eighty-six consecutive children treated surgically at our hospital from April 2005 to June ...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/j.1757-7861.2011.00153.x
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:To determine whether the rates of postoperative complications, rate of readmission, cumulative transfusion volume, and length of stay (LOS) differ between simultaneous total hip arthroplasty (THA) and staged bilateral THA and to assess whether the length of the interval between staged procedures influences s...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12617
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:To analyze the curative effect of TiRobot surgical robotic navigation and location system-assisted percutaneous sacroiliac screw fixation and percutaneous sacroiliac screw by traditional fluoroscopy, and to summarize the safety and benefits of TiRobot. METHODS:A total of 91 patients with pelvic posterior ri...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12461
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of residual varus and valgus deformity on the stress distribution of the knee joint after tibial fracture malunion. METHODS:Fourteen adult cadaver specimens were selected to establish the models of tibial fractures, which were fixed subsequently at neutral position (anatomical reduc...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12668
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVES:This research aimed to investigate the relative level of Runt-related transcription factor 2 (RUNX2) in giant cell tumor of bone (GCTB). Through the histopathological similarities between osteoporosis and GCTB, the biological functions of exogenous RUNXS were demonstrated in GCTB cell lines. This generated a...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12568
更新日期:2020-04-01 00:00:00
abstract::A 66-year-old woman had sustained crush injury 3 hours prior to her presentation to our hospital. The diagnosis was defined as lateral tibial plateau fracture of the right knee (Schatzker III). Supine position was set up and a pad was put under the affected hip. After sterilization of the surgical field the sterilized...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/os.12205
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Total knee arthroplasty (TKA) is one of the most universal and effective means for treating terminal stage osteoarthritis (OA) of knee. Accurate intramedullary guide of femur is the basis for the distal femoral cuts. Determining the surgical transepicondylar axis (sTEA) is the key to reconstruction of the fem...
journal_title:Orthopaedic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1111/os.12619
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the results of treatment of osteonecrosis of the femoral head by structural augmentation through a routine core decompression procedure combined with insertion of cannulated bone screws incorporating autogenous bone graft and biomaterial containing decalcified bone matrix. METHODS:From February 2...
journal_title:Orthopaedic surgery
pub_type: 杂志文章
doi:10.1111/j.1757-7861.2008.00008.x
更新日期:2009-02-01 00:00:00