Abstract:
INTRODUCTION:Fracture neck of femur (hip fracture) is a very common problem among old age group. Such elderly patients usually have some comorbidities for which they may use anti-platelet therapy (such as clopidogrel, aspirin, or others) for long duration (chronic use). These anti-platelet medications might make the blood thin and increase bleeding tendency. So, if these elderly people present with fracture neck of femur requiring surgical intervention, they might be at increased risk of bleeding and other complications if the use of these anti-platelet agents was continued throughout the peri-operative period. OBJECTIVES:This current study aims to find out whether it is safe or not to continue the use of anti-platelet drugs during the peri-operative period in patients with hip fracture surgery. If it is safe and there are no complications, then there is no harm to continue the use of these drugs peri-operatively without any surgical delay. But if it is unsafe and there is increased risk of bleeding or blood transfusion or other complications, then such medications must be stopped peri-operatively. Thus, the medical practice and care will be improved to achieve patient safety. METHODS:It was a retrospective study which reviewed files and notes of patients who had hip fracture surgery. These patients were divided into 2 groups. First group was on long-term anti-platelet treatment (APTG), and the use of these medicines continued during the peri-operative phase. The second group was not on anti-platelet treatment at all (NAPTG). Then, a comparison was done between both groups in terms of the following parameters during the peri-operative (pre- and post-operative) period: (i) intra-operative blood loss, (ii) operative time in minutes (length of surgery), (iii) pre-operative haemoglobin level, (iv) the need for blood transfusion, (v) haematoma formation, (vi) re-operation for any reason, (vii) post-operative wound infection, and (viii) duration in days to achieve complete wound healing post-operatively. So these measures are good parameters to assess bleeding tendency and bleeding risk. Data was collected, and statistical analysis was done using Pearson's chi-squared test and independent sample t test as appropriate. RESULTS:325 participants were enrolled in the study. There were 163 patients in the APTG (Anti-Platelet Treatment Group) and 162 patients in the NAPTG (Non-Anti-Platelet Treatment Group). It has been found that there was no statistically significant difference between the APTG and NAPTG in terms of these peri-operative parameters: (i) intra-operative blood loss, (ii) operative time in minutes (length of surgery), (iii) pre-operative haemoglobin level, (iv) the need for blood transfusion, (v) haematoma formation, (vi) re-operation for any reason, (vii) post-operative wound infection, and (viii) duration in days to achieve complete wound healing post-operatively (P > 0.650). CONCLUSION:It is safe to continue the use of anti-platelet therapy throughout the peri-operative phase in patients with hip fracture surgery. The continuation of such therapy is not associated with increased risk of bleeding or blood transfusion or other complications in patients who had surgical treatment for femoral neck fracture.
journal_name
Int Orthopjournal_title
International orthopaedicsauthors
Abdulhamid AKdoi
10.1007/s00264-020-04633-7subject
Has Abstractpub_date
2020-09-01 00:00:00pages
1805-1813issue
9eissn
0341-2695issn
1432-5195pii
10.1007/s00264-020-04633-7journal_volume
44pub_type
杂志文章abstract::We describe fives cases of an unusual type of injury to the wrist which has been seen in Sikhs, an ethnic population in India. It is caused by entrapment of the kara, an iron bangle, which is traditionally worn as one of five compulsory religious symbols. The injuries were an open transtriquetral palmar perilunar disl...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00210533
更新日期:1991-01-01 00:00:00
abstract::We developed a locking screw plate system for the stabilisation of distal radial fractures, which can be inserted through a standard volar approach and in which the locking mechanism allows early post-operative mobilisation. Forty-nine patients with 50 fractures underwent surgical treatment; 66% were type C fractures....
journal_title:International orthopaedics
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doi:10.1007/s00264-002-0393-x
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journal_title:International orthopaedics
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journal_title:International orthopaedics
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doi:10.1007/s00264-002-0346-4
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640000209
更新日期:2001-01-01 00:00:00
abstract::We performed a clinical and radiographic review of 15 patients (19 limbs) with longitudinal deficiency of the tibia treated between 1981 and 2001. Ten limbs with Kalamchi type I deficiencies were managed by through-knee amputation. Five type II deficiencies were treated by foot ablation and tibiofibular synostosis, ei...
journal_title:International orthopaedics
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doi:10.1007/s00264-003-0490-5
更新日期:2003-01-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-006-0261-1
更新日期:2007-12-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-001-0319-z
更新日期:2002-01-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,随机对照试验
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更新日期:2013-06-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00271094
更新日期:1980-01-01 00:00:00
abstract::Fifty-four consecutive acute Achilles tendon ruptures were treated with end-to-end suture augmented with gastrocnemius fascial flaps. Surgery was performed within 24 h. Mean patient age was 35 (23-57) years, and 46 were men. Mean follow-up time was 4.8 (2-8) years. At follow-up, the mean visual analogue scale for pain...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-004-0598-2
更新日期:2005-02-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/BF00179971
更新日期:1995-01-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00267036
更新日期:1985-01-01 00:00:00
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journal_title:International orthopaedics
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doi:10.1007/s00264-012-1746-8
更新日期:2013-03-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-017-3716-7
更新日期:2018-12-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640000218
更新日期:2001-01-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2020-11-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,随机对照试验
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更新日期:2015-02-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2008-08-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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journal_title:International orthopaedics
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-01-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
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更新日期:2014-05-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-008-0698-5
更新日期:2009-12-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/BF00265749
更新日期:1988-01-01 00:00:00
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journal_title:International orthopaedics
pub_type: 古典文章,历史文章,杂志文章
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更新日期:2017-03-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00180230
更新日期:1994-10-01 00:00:00
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更新日期:2004-10-01 00:00:00
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journal_title:International orthopaedics
pub_type: 古典文章,历史文章,杂志文章
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更新日期:2015-12-01 00:00:00
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journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00265739
更新日期:1988-01-01 00:00:00
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pub_type: 杂志文章
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