Effects of fracture displacement and operation method on perioperative blood loss of femoral neck fractures

Abstract

Objective To investigate the effects of fracture displacement and operation method on perioperative blood loss of femoral neck fractures. Methods From December 2013 to October 2014, 130 cases (58 males and 72 females, aged from 18 to 91 years, with an average age of 71.1±12.9 years) with femoral neck fractures were retrospectively analyzed for the perioperative blood loss. The degree of displacement was described according to Garden's grades. According to the degree of fracture displacement, the patients were divided into two groups: Garden Ⅰ-Ⅱ group and Garden Ⅲ-Ⅳ group, and patients' preoperative hidden blood loss was compared between two groups. According to the degree of fracture displacement and the method of operation, the patients were divided into four groups: Group 1 indicates the group in which patients received cannulated screws fixation for Garden gradeⅠ-Ⅱ; Group 2 in which patients received hemiarthroplasty for Garden gradeⅠ-Ⅱ; Group 3 in which patients received cannulated screws fixation for Garden grade Ⅲ-Ⅳ; Group 4 in which patients received hemiarthroplasty for Garden grade Ⅲ-Ⅳ; and variation in the following four parameters was analyzed: the dominant blood loss, postoperative hidden blood loss, total hidden blood loss, total blood loss in the four different groups. Results For the Garden grade Ⅲ-Ⅳ femoral neck fracture group, the preoperative hidden blood loss was significantly higher than that of the Garden grade Ⅰ-Ⅱ femoral neck fracture group (t=2.267,P=0.001). The dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss volume and total blood loss volume of hemiarthroplasty groups (402.1±36.8 ml, 641.3±53.2 ml, 880.7±61.7 ml, 1 246.1±76.7 ml) were higher than those of the cannulated screws fixation group (45.8±34.9 ml, 301.9±50.6 ml, 436.6±58.6 ml, 478.5±72.9 ml). Conclusion The perioperative hidden blood loss is mainly related with the degree of fracture displacement, the greater the degree of fracture displacement, the more the preoperative hidden blood loss. While the dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss volume and total blood loss volume are mainly related to the method of operation, the blood loss in which patients received hemiarthroplasty should be increased significantly. Key words: Femoral neck fractures; Perioperative period; Blood loss, surgical