A PROSPECTIVE COMPARATIVE STUDY TO ASSESS THE EFFECT OF TRANEXAMIC ACID IN PATIENTS UNDERGOING CEPHALOMEDULLARY NAILING FOR HIP FRACTURES

Abstract

Background: The main objective of the present study was to assess the effect of TXAin patients undergoing cephalomedullary nailing xation of hip fractures in comparison with patients not receiving TXA. Methods: This is a prospective comparative study done with eligible in-patients (n=71) with hip fractures, planned for cephalomedullary nailing in Department of Orthopaedics and Traumatology, Meenakshi Mission Hospital and Research Centre, Tertiary Health Care Centre, Madurai, Tamilnadu. All eligible patients were divided into two groups viz. Group T and Group S. For Group T (TXA Group), intravenous infusion of TXA at the dose level of 15 mg/kg was given at the time of inducing anaesthesia i.e., 15 minutes before skin incision in surgery. For Group S (Saline Group) intravenous infusion of normal saline at the dose level of 15 mg/kg was given at the time of inducing anaesthesia i.e., 15 minutes before skin incision in surgery. Group T and Group S were compared and evaluated for blood loss and requirement of whole blood transfusion. Results: Majority of the study subjects i.e., 80% had Intertrochanteric femur fracture and majority of the study subjects i.e., 68.60% underwent closed reduction and internal xation with long Proximal Femoral Nail (PFN). Furthermore, our study ndings delineated that study subjects who received TXA had 79.8 mL lesser peri- operative blood loss as compared to control subjects and this difference was statistically signicant (p = 0.002) between the groups. In addition, number of study subjects who required blood transfusion was higher (44.44%) among Group S as compared to Group T (20.00%) and this difference was also statistically signicant (p<0.05) between the groups. Conclusion: Tranexamic acid play a signicant role in reducing postoperative blood loss and blood transfusion when used intravenously in patients undergoing cephalomedullary nailing xation of hip fractures.