[Clinical analysis of obvious and hidden blood loss in inter-trochanter fracture patients treated with proximal femoral nail anti-rotation and dynamic hip screw].

OBJECTIVE: To analyze the obvious and hidden blood loss before and after operations in the inter-trochanter fracture patients treated with proximal femoral nail anti-rotation (PFNA) and dynamic hip screw (DHS) to provide the data support for clinical perioperative period treatment.

METHODS: The clinical data of 216 cases of inter-trochanter fracture patients treated with PFNA and 168 cases of inter-trochanter fracture patients treated with DHS from Dec. 30, 2001 to Sep. 30, 2010, and the obvious, hidden blood loss and blood transfusion before and after operations were retrospectively analyzed, using SPSS 13.0 statistical package.

RESULTS: The PFNA group: The mean blood loss of (48.9±2.8) mL was found in 216 cases of inter-trochanter fracture patients during operation. The mean obvious blood loss was (62.3±3.8) mL while the hidden blood loss was (385.0±6.2) mL. The DHS group: The mean blood loss of (124.9±7.8) mL was found in 168 cases during operation. The mean obvious blood loss was (73.9±4.7) mL and the hidden blood loss was (243.4±6.3) mL after operation. The blood loss during operation and obvious blood loss after operation of DHS was larger than that of PFNA, while the hidden blood loss of DHS was smaller than that of PFNA. The gross total blood loss and the hidden blood loss of group PFNA was bigger than that of DHS group.

CONCLUSION: There were much hidden blood loss in both PFNA and DHS group for inter-trochanter fracture internal fixation after operation. This reminds surgeons to monitor the life vital signs after PFNA or DHS internal fixation operation in order to decrease the complication.