Factors affecting blood loss during open reduciton and internal fixation (ORIF) of isolated closed femoral fractures at Mulago Hospital

Abstract

Background: In open reduction and internal fixation (ORIF) of femur, blood loss is characterised by slow continuous haemorrhage characteristic of muscle stripping, subperiosteal dissection and osteotomy. Blood loss may however be minimised by meticulous surgical technique which is perfected by training and experience. Objective: To assess the amount of blood loss during ORIF of isolated closed femoral fractures in Mulago Hospital. Setting : Mulago National Hospital ,Uganda. Design: This was a cross-sectional analytical study. Methods: Purposive sampling was used. These were patients in Ward 7 of Mulago Hospital. The allowable blood loss was calculated using the haemodilution method . Blood loss was calculated by weighing dry and blood soaked gauze swabs. The amount of intravenous fluids was recorded. The patient was monitored for pulse rate, blood pressure and urine output. Data processing and analysis was done by use of SPSS-10 package. Results: The mean blood loss intraoperatively was 930mls. Long duration of surgery was associated with more blood loss. Older fractures bled more than fresh fractures. Use of diathermy was associated with significantly less blood loss. Conclusion: Fractures should be fixed early and use of diathermy should be encouraged to minimise blood loss. East African Orthopaedic Journal, Vol. 4: September 2010