title: [Analysis of the blood loss in perioperative period of femoral intertrochanteric fractures in old patients treated with different internal fixations].
abstract: OBJECTIVE
  To analyze blood loss in perioperative period of femoral intertrochanteric fractures in old patients treated with Gamma interlocking intramedullary nail (Gamma3), proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS), and to comprehend the character of blood loss in perioperative period of femoral intertrochanteric fractures.
  
  
  METHODS
  A retrospective analysis was made of the medical records of 408 old patients with femoral intertrochanteric fractures admitted to our hospital between January 1, 2007 and to December 31, 2012. The estimated blood loss was calculated by Gross equation, according to the height, weight and changes of blood test pre- and post-operation and the differences of blood loss among Gamma3 group, PFNA group and DHS group were compared. The statistical analysis was conducted using One-Way ANOVA analysis with SPSS 13.0. A P value less than 0.05 was considered statistically significant.
  
  
  RESULTS
  In the Gamma3 group (96 cases, 39 males, 57 females), the average operation time was (74.7 ± 25.0) min, the mean obvious blood loss was (103.5 ± 83.0) mL, the mean total blood loss was (831.9 ± 474.8) mL, and the mean hidden blood loss was (728.3 ± 455.5) mL. In the PFNA group (84 cases,31 males, 53 females), the average operation time was (69.0 ± 27.1) min, the mean obvious blood loss was (91.5 ± 111.4) mL, the mean total blood loss was (825.7 ± 478.0) mL, and the mean hidden blood loss was (734.2 ± 455.7) mL. In the DHS group (40 cases, 14 males, 26 females), the average operation time was (97.5 ± 25.0) min, the mean obvious blood loss was (283.6 ± 142.1) mL, the mean total blood loss was (695.7 ± 502.4) mL, and the mean hidden blood loss was (412.1 ± 457.6) mL.
  
  
  CONCLUSIONS
  By comparing the three kinds of internal fixation methods we find that the Gamma3 and PFNA groups have a smaller size of incision, shorter time of operation and less intraoperative bleeding than the DHS group, but there is a considerable perioperative hidden blood loss. We should give enough attention to reducing the incidence of postoperative complications.
authors.affiliation: Department of Orthopaedic Surgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Guo-Jin
authors.initials: GJ
authors.lastname: Hou
authors.forename: Fang
authors.initials: F
authors.lastname: Zhou
authors.forename: Zhi-Shan
authors.initials: ZS
authors.lastname: Zhang
authors.forename: Hong-Quan
authors.initials: HQ
authors.lastname: Ji
authors.forename: Yun
authors.initials: Y
authors.lastname: Tian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001810:Blood Volume; D001858:Bone Nails / Q000009:adverse effects; D001863:Bone Screws / Q000009:adverse effects; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059035:Perioperative Period; D012189:Retrospective Studies