Effect of the degree of displacement of femoral neck fracture and surgical methods on perioperative blood loss

Abstract

Objective To investigate the effect if degree of displacement of femoral neck fractures and surgical methods on perioperative blood loss. Methods The clinical data of 120 patients with femoral neck fracture from January 2013 to January 2015 were retrospectively analyzed. The clinical data of patients with femoral neck fracture were analyzed, and the degree of fracture displacement was graded according to the Garden classification criteria, with 41 cases of Garden Ⅰ - Ⅱ type (Garden Ⅰ - Ⅱ group), 79 cases of type Garden Ⅲ-Ⅳ (GardenⅢ-Ⅳ group). The preoperative occult blood loss and hemoglobin level were compared between the two groups by statistical SPSS 20.0 software. According to the different surgical methods in each group, in the Graden Ⅰ-Ⅱ group, 30 patients with hollow screw fixation as Garden Ⅰ-Ⅱ fixation group, 11 patients with hemiarthroplasty as Garden Ⅰ-Ⅱ arthroplasty group; In the Garden Ⅲ-Ⅳ group, 14 patients with hollow screw fixation as Garden Ⅲ-Ⅳ fixation group, 65 patients with hemiarthroplasty as Garden Ⅲ-Ⅳ arthroplasty group. The peroperative overt blood loss and total blood loss, total occult blood loss, occult blood loss after operation in the four groups were compared by statistical SPSS 20.0 software. Results When admitted to hospital, hemoglobin level had no significant difference between the Garden Ⅰ - Ⅱgroup and the GardenⅢ-IV(P>0.05). Both groups of preoperative hemoglobin levels were decreased, and the Garden group Ⅰ - Ⅱhemoglobin level was significantly higher than that in the GardenⅢ-Ⅳ group, the difference was statistically significant (P 0.05); The postoperative blood transfusion rate and the average volume of blood transfusion of hemiarthroplasty were higher than that of the hollow screw fixation, the differences were statistically significant (P<0.05). Conclusions There is a significant correlation between the degree of fracture displacement and preoperative occult blood loss, the greater the degree of fracture displacement, the more occult blood loss before operation. Patients with peroperative overt blood loss and postoperative bleeding volume, total occult blood loss, occult blood loss volume and surgical methods have obvious correlation, compared with hollow screw internal fixation, hip replacement for the treatment of patients with blood loss was significantly more. Key words: Femoral neck fracture; Joint displacement; Perioperative blood loss; Occult blood loss; Surgical