Analiza sniženja razine hemoglobina nakon prijma u bolesnika s prijelomom bedrene kosti

The studies that evaluated blood loss during hip surgery found a relatively small loss that does not explain the large hemoglobin drop postoperatively. The aim of this study was to determine the fall in hemoglobin level after admission and rehydration in patients with hip fractures and to identify the patients that need blood transfusion. This retrospective study included data on 374 patients with hip fracture with surgery delayed by more than 24 hours and complete blood count repeated prior to surgery after fluid resuscitation for a minimum of 24 hours. The hemoglobin level (g/L) was analyzed after admission and after rehydration. The results were compared by Student’s t-test. The mean hemoglobin drop was 6.1 g/L, 12.05 g/L and 16.52 g/L for capsular, pertrochanteric and subtrochanteric fractures, respectively. This hemoglobin drop was statistically significant in all frac-ture types. The significant drop of preoperative hemoglobin should be taken in consideration when planning transfusion for hip fracture patients. Collection of blood sample after rehydration preopera-tively would enable prompt diagnosis and treatment of anemia in these patients, along with proper transfusion planning and cross-matching.Studije koje su procjenjivale gubitak krvi tijekom operacije kuka utvrdile su relativno mali gubitak koji ne objašnjava veliko sniženje razine hemoglobina nakon operacije. Cilj ovog istraživanja bio je utvrditi pad razine hemoglobina nakon prijma i rehidracije u bolesnika s prijelomom bedrene kosti te identificirati bolesnike u kojih je potrebna transfuzija krvi. Ova retrospektivna studija obuhvatila je 374 bolesnika s prijelomom kuka kod kojih je operacija odgođena za više od 24 sata i s ponovljenom kompletnom krvnom slikom prije operacije nakon nadomještanja tekućine kroz najmanje 24 sata. Razina ­hemoglobina (g/L) analizirana je nakon prijma i nakon rehidracije. Rezultati su uspoređeni pomoću Studentova t-testa. Srednja vrijednost sniženja hemoglobina bila je 6,1 g/L kod kapsularnih, 12,05 g/L kod pertrohanternih prijeloma i 16,52 g/L kod subtrohanternih prijeloma. Takvo sniženje hemoglobina bilo je statistički značajno kod svih vrsta prijeloma. Zna­čajno prijeoperacijsko sniženje hemoglobina treba uzeti u obzir kad se planira transfuzija krvi kod bolesnika s prijelo-mom bedrene kosti. Uzimanje uzoraka krvi prijeoperacijski nakon rehidracije omogućit će brzo dijagnosticiranje i liječenje ane­mije kod ovih bolesnika, ispravno planiranje transfuzije i križne probe

Analysis of the Arthroscopically Diagnosed Soft-Tissue Injuries Associated With the Distal Radius Fractures

AIM: The aim of this study was to analyze the frequencies of these soft-tissue injuries and to describe the arthroscopic technique used for their diagnosis.METHODS: The prospective study included 85 patients with operatively treated distal radius fracture. Wrist arthroscopy was used to identify the associated lesions of triangular fibrocartilage complex (TFCC), scapholunate ligament (SL) and lunitriquetral ligament (LT), extrinsic ligaments, and chondral lesions.RESULTS: Wrist arthroscopy identified TFCC injury in 72.9%, SL injury in 65.9%, LT injury in 17.7%, extrinsic ligaments in 49.4% and chondral lesion in 30.6% of the patients. 87.1% of the patients had at least one of the major structures injured (TFCC, SL or LT). The presence of the ulnar styloid fractures significantlly correlated with with the associated LT lesion, with the LT lesion type, and with the lesion of both SL and LT ligament. If the distal radius fracture was intraarticular there was no correlation with the finding of any associated soft-tissue lesion.CONCLUSIONS: The frequency of the associated soft-tissue lesions in distal radius fractures is high. Ulnar styloid fracture was identified as risk factor for associated LT lesion, as well as combined lesion of both scapholunate and luntriquetral ligament