Comparison of hemoglobin changes among subtypes of preoperative fracture classification for intertrochanteric fractures of the femur
Objective To compare the differences in preoperative hemoglobin changes between subtypes of Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association(AO/OTA)and Evans classifications for intertrochanteric fractures of the femur,and evaluate the feasibility of using the above two classifications to predict preoperative hemoglobin changes.Methods A total of 210 patients with hip fracture admitted to Beijing Shijingshan Hospital from October 2017 to June 2021 were selected.Baseline data,hemoglobin,use of anticoagulants before injury,intravenous fluid volume after injury,and use of low molecular weight heparin sodium after injury were collected,and hemoglobin changes among different subtypes were compared according to AO/OTA and Evans classifications of intertrochanteric fractures of the femur.Results The hemoglobin decreased in patients with intertrochanteric fractures of the femur 3 days after injury.AO/OTA classification:The 3 days after injury,hemoglobin in patients with type A1 was significantly higher than that in patients with type A2 and type A3(P<0.05),and the change of hemoglobin was significantly lower than that in patients with type A2 and type A3(P<0.05),while there was no statistically significant difference between A2 and A3(P>0.05).Evans classification:The 3 days after injury hemoglobin of type Ⅰa was significantly higher than that of type Ⅰc,type Ⅰd and type Ⅱ(P<0.05),and type Ⅰb was significantly higher than that of type Ⅰd and type Ⅱ(P<0.05).Three days after injury,the change of hemoglobin of type Ⅰa was significantly lower than that of type Ⅰc,type Ⅰd and type Ⅰ(P<0.05),type Ⅰb was significantly lower than that of type Ⅰd and type Ⅱ(P<0.05),and typeⅠc was significantly lower than that of type Ⅰd and type Ⅱ(P<0.05),while there is no statistically significant difference betweenⅠd type and Ⅱ type(P>0.05).Conclusion The decrease in hemoglobin levels within 3 days after injury in patients with intertrochanteric fractures of the femur is partially positively correlated with AO/OTA and Evans subtypes.AO/OTA classification and Evans classification may not be ideal fracture classification for predicting preoperative hemoglobin changes.
Intertrochanteric fractures of the femurHemoglobinHidden hemorrhageFracture typePreoperation
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