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Comparison of single versus double tranexamic acid dose regimens in reducing post-operative blood loss following intramedullary nailing of femoral fracture nonunions

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A Letter to the Editor to this article was published on 23 October 2021

A Letter to the Editor to this article was published on 21 October 2021

Abstract

Introduction and aim of study

Tranexamic acid has been found to be effective in reducing peri-operative blood loss and is widely used across surgical specialties including orthopaedic surgery. However, there is still no consensus on the most appropriate and effective dose regimen. This study therefore compared the efficacy of single versus double dose regimens in patients that had interlocking intramedullary nailing by assessing the volume of drain output with the objective of determining the more effective regimen.

Methods

The study was a multicenter prospective study amongst adult patients who had interlocking intramedullary nailing for femoral nonunions. Following ethical approval, consent was obtained from eligible patients who were randomly assigned into two study groups. Group A patients had single pre-incision tranexamic acid bolus of one gram while group B patients had a second (repeat) one gram bolus (at the completion of wound closure). The volume of drain output at 48 h postop was the primary outcome measure and data collection was via an online data collection form linked to the google drive of the principal investigator. The mean of the drain output of the two groups was compared for statistical significance.

Results

A total of 61 patients participated in the study with 30 patients in group A and 31 patients in group B. The demographic data and duration of fracture were comparable in the two groups. Group A had a mean drain volume of 274.80 ml (± 103.93 ml) while group B had a mean of 187.94 ml (± 41.95 ml) and the difference was found to be statistically significant. (P, 0.000).

Conclusion

The findings suggest that double dose perioperative tranexamic acid regimen is superior to single-dose peri-operative tranexamic acid regimen in reducing post-operative blood loss in patients undergoing interlocking intramedullary nailing for femoral nonunions.

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Data availability

Relevant data and materials can be obtained at reasonable request from the corresponding author.

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Authors and Affiliations

  1. Orthopaedic Unit, Department of Surgery, Federal Medical Centre Bida, P.M.B. 14, Bida, Niger State, Nigeria

    Olaoluwa Moses Shodipo & John Adeniran James

  2. Department of Orthopaedic Surgery, Federal Medical Centre Birnin-Kudu, Birnin-Kudu, Jigawa State, Nigeria

    Hamzah Ibrahim Jatto

  3. Department of Orthopaedics, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria

    Ali Mohammed Ramat

  4. Orthopaedic Unit, Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital Bauchi, Bauchi, Bauchi State, Nigeria

    Shaphat Shuaibu Ibrahim

  5. Orthopaedics and Trauma Department, Usmanu Danfodiyo University Teaching Hospital Sokoto, Sokoto, Sokoto State, Nigeria

    Lukman Olalekan Ajiboye

  6. Department of Orthopaedics, National Orthopaedic Hospital Dala, Kano, Kano State, Nigeria

    Soluideen Adebayo Arojuraye

  7. Department of Orthopaedics and Trauma Surgery, National Orthopaedic Hospital Igbobi, Lagos, Lagos State, Nigeria

    Adetunji Mapaderun Toluse

Authors
  1. Olaoluwa Moses Shodipo
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  2. Hamzah Ibrahim Jatto
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  3. Ali Mohammed Ramat
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  4. Shaphat Shuaibu Ibrahim
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  8. Adetunji Mapaderun Toluse
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Contributions

All authors whose names appear in this submission: (1) made substantial contributions to the study conception, design, data acquisition and analysis; (2) were involved in manuscript preparation; (3) approved the version submitted for publication; and (4) agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Olaoluwa Moses Shodipo.

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Ethical approval

Ethical approval was obtained from the Health Research and Ethics Committee (FMCB/HCS/HREC/APPR/VOL 2/10/2020).

Consent to participate

Informed consent for participation was obtained from all participating patients.

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Informed consent for publication was obtained from all study participants.

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The authors declare no competing interests.

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Shodipo, O.M., Jatto, H.I., Ramat, A.M. et al. Comparison of single versus double tranexamic acid dose regimens in reducing post-operative blood loss following intramedullary nailing of femoral fracture nonunions. International Orthopaedics (SICOT) 46, 97–101 (2022). https://doi.org/10.1007/s00264-021-05220-0

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  • DOI: https://doi.org/10.1007/s00264-021-05220-0

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