Factors affecting blood loss and blood transfusion in patients with proximal humeral fractures

2019 ◽  
Vol 28 (6) ◽  
pp. e165-e174 ◽  
Author(s):  
Dominik Malcherczyk ◽  
Antonio Klasan ◽  
Arne Ebbinghaus ◽  
Brandon Greene ◽  
Martin Bäumlein ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Factors Affecting

scholarly journals MutiLoc Nail Versus Philos Plate in Treating Proximal Humeral Fractures: A Retrospective Study Among the Alderly

2021 ◽  
Vol 12 ◽  
pp. 215145932110439
Author(s):  
Guoyun Bu ◽  
Weitang Sun ◽  
Jian’an Li ◽  
Tao Yang ◽  
Mingxin Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Operation Time ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Plate Group ◽  
Philos Plate ◽  
Fracture Types

Background Proximal humeral fractures (PHFs) account for 4–5% of all fractures in the elderly. There is still a controversy among the treatments in the displaced PHFs. Our aim was to explore the clinical outcome of PHFs with the treatment of MultiLoc nail or Philos plate in the elderly patients. Methods A total of 82 sustained elderly patients with PHFs were finally recruited between Dec 2016 and Dec 2017. 34 patients were treated with MultiLoc nail and 48 patients were treated with Philos plate. The demographics, fracture types, blood loss, operation time, union time, postoperative complications, visual analog scores (VASs), Constant scores, American Shoulder and Elbow Scores (ASESs), and neck-shaft-angle (NSA) between the two groups were compared. Results No differences were observed in the demographics, fracture types, VAS, Constant scores, and ASES scores between the two groups at final follow-up. Compared with the plate group, the blood loss, operation time, and union time were significantly lower in the nail group (all P < .05). The rate of general complications was 54.17% in the plate group, which was higher than that in the nail group (26.47%, P = .01). Three patients experienced reoperation in the plate group (3/48; 6.25%), but none in the nail group. Although there were no significant differences in intraoperative NSA between the two groups, the NSA at final follow-up in the nail group was much higher than the plate group (137.55 ± 5.53°vs 134.47 ± 5.92°, P = .02). Conclusions Multiloc intramedullary nail showed the similar effectiveness of final VAS, final Constant scores, and ASES scores in PHFs treatment with Philos plate. However, MultiLoc nail is superior to Philos plate in blood loss, operation time, complications, reoperation rate, and the change of NSA.

scholarly journals Functional outcome evaluation of Neer’s two part and three part proximal humeral fractures treated by percutaneous K-wire fixation in a tertiary care hospital in North India: a prospective study of 21 patients

2021 ◽  
Author(s):  
Pankaj Spolia ◽  
Abdul Ghani
Keyword(s):  
Soft Tissue ◽  
Blood Loss ◽  
Prospective Study ◽  
Functional Outcome ◽  
Tissue Damage ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Wire Fixation ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The treatment of proximal humeral fractures is controversial. The advantages of percutaneous Kirschner’s wire (K-wire) fixation include preservation of periosteal blood supply, minimal blood loss, less soft tissue damage and shorter hospital stay. The aim of this study was to evaluate the 2 part and 3 part proximal humeral fractures in terms of functional outcome at final follow up.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study of 21 patients aged 20 to 60 years with mean age of 44.2 years including two part and three part proximal humeral fractures based on Neer’s classification, treated by percutaneous K-wire fixation. Functional outcome was assessed by Constant-Murley score at 1 year follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> On the basis of Neer’s classification, 13 patients had 2 part fracture, 8 patients had 3 part fracture. Radiological union was achieved within 7 to 15.2 weeks, with an average of 11.6 weeks. The mean constant score at 1 year follow up was 78.2, range (42 to 96). In the present study, complications were seen in 8 (38.1%) patients. The results were in proximity with the existing literature.</p><p class="abstract"><strong>Conclusions:</strong> Percutaneous fixation is minimally invasive technique with preservation of periosteal blood supply, minimal blood loss, less soft tissue damage, surgery can be done under brachial plexus block, less chances of avascular necrosis, shorter hospital stay, no hardware in situ, thus no hardware symptoms, leaves no surgical scar and lowers the rate of complications.</p><p class="abstract"> </p>

scholarly journals Severe intraoperative bleeding predicts the risk of perioperative blood transfusion after robot-assisted radical prostatectomy

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Alessandro Tafuri ◽  
Aliasger Shakir ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Univariate Analysis ◽  
Operating Time ◽  
Primary Treatment ◽  
Intraoperative Blood Loss ◽  
Robot Assisted ◽  
Intraoperative Bleeding ◽  
Perioperative Blood Transfusion

AbstractTo evaluate potential factors associated with the risk of perioperative blood transfusion (PBT) with implications on length of hospital stay (LOHS) and major post-operative complications in patients who underwent robot-assisted radical prostatectomy (RARP) as a primary treatment for prostate cancer (PCa). In a period ranging from January 2013 to August 2019, 980 consecutive patients who underwent RARP were retrospectively evaluated. Clinical factors such as intraoperative blood loss were evaluated. The association of factors with the risk of PBT was investigated by statistical methods. Overall, PBT was necessary in 39 patients (4%) in whom four were intraoperatively. Positive surgical margins, operating time and intraoperative blood loss were associated with perioperative blood transfusion on univariate analysis. On multivariate analysis, the risk of PBT was predicted by intraoperative blood loss (odds ratio, OR 1.002; 95% CI 1.001–1.002; p < 0.0001), which was associated with prolonged operating time and elevated body mass index (BMI). PBT was associated with delayed LOHS and Clavien–Dindo complications > 2. In patients undergoing RARP as a primary treatment for PCa, the risk of PBT represented a rare event that was predicted by severe intraoperative bleeding, which was associated with increased BMI as well as with prolonged operating time. In patients who received a PBT, prolonged LOHS as well as an elevated risk of major Clavien–Dindo complications were seen.

scholarly journals Plate Fixation for Irreducible Proximal Humeral Fractures in Children and Adolescents—A Single-Center Case Series of Six Patients

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 635
Author(s):  
Florian Freislederer ◽  
Susanne Bensler ◽  
Thomas Specht ◽  
Olaf Magerkurth ◽  
Karim Eid
Keyword(s):  
Closed Reduction ◽  
Biceps Tendon ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Constant Murley Score ◽  
Fractures In Children ◽  
Initial Surgery ◽  
Conjoint Tendon

Background: Recommended treatment for severely displaced proximal humeral fractures in children is the closed reduction and percutaneous fixation by K-wires or intramedullary nailing. Methods: From January 2016 to January 2017 6, 21 children/adolescents (range 8 to 16 years) with proximal humeral fractures were treated surgically for severe displacement. In these six patients, several attempts of closed reduction were unsuccessful, and an open reduction was performed. The humeral head was fixed with a 3.5 mm T-plate without affecting the growth plate. Plate removal was performed at a mean interval of 132 days after initial surgery. Two years after initial surgery, the clinical outcome was assessed by the Constant–Murley score and QuickDASH score (including sport/music and work) and the shoulder joint was evaluated with a standardized sonographic examination for the rotator cuff and the conjoint tendon. Results: In all six patients, dorsal displacement of the fracture was irreducible due to the interposition of tendinous or osseous structures. Intraoperatively, the interposed structures were the long biceps tendon in two, periosteal tissue in two, a bony fragment in one, and the long biceps tendon together with the conjoint tendon in one case. At mean follow-up of 26 months (range 22 months to 29 months), patients showed very good clinical results with an excellent mean Constant–Murley score of 97.5 (range 91 to 100) and mean QuickDASH score (including sport/music and work) of 5.5 (range 0–20.8). An X-ray follow-up 6 weeks after surgery demonstrated early consolidation and correct alignment in all patients. A sonographic evaluation at 2 years post injury showed that the biceps and the conjoined tendon were intact in all patients. Conclusions: If a proximal humeral fracture is not reducible by closed means, a tissue entrapment (most likely biceps tendon) should be considered. Treatment with an open reduction and plate fixation yields very good clinical and radiological results and preserves interposed structures as the biceps and conjoint tendon.

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