Evaluation of Efficacy of Tranexamic Acid on Blood Loss in Surgically Managed Intertrochanteric Fractures

Intertrochanteric (IT) fracture surgeries make up a significant portion of trauma operations worldwide. The routine use of tranexamic acid (TXA) for these surgeries is not common in current practice at most places. This prospective study evaluated its efficacy in reducing perioperative blood loss and accentuating its potential for a better outcome.

A total of 100 patients were divided equally into two groups, A and B. Group A was given preoperative intravenous (IV) TXA and intraoperative topical TXA through the drain, while Group B was given preoperative and intraoperative normal saline. Both groups were comparable in age, body mass index, preoperative hemoglobin (Hb), surgery performed, and duration of surgery.

The mean drain volume, postoperative Hb, fall of Hb, and total blood loss were all significantly less in Group A as compared to Group B (P < 0.01). None of the patients in either group received more than one unit of blood transfusion. No complications were seen in any of the patients till the final follow-up.

In comparison to other studies, our study is in agreement that TXA overall helps in blood conservation; however, our study is unique in the way that the combination of preoperative IV and intraoperative topical TXA has resulted in the best possible results.