| Objective To investigate the effect of the ratios of marrow cavity diameter and intramedullary nail diameter from different layers on hidden blood loss, overt blood loss and total blood loss in the perioperative period during using PFNA II for femoral intertrochanteric fracture. Methods We retrospectively studied 70 patients treated in our hospital from January 2015 to November 2016. Their age, gender, height, fracture type, preoperative and postoperative HTC, and overt blood loss during operation were analyzed. Total blood loss and hidden blood loss were calculated using CROSS equation. According to post-operative X-ray results, the ratios of marrow cavity diameter and intramedullary nail diameter from different layers, start of funnel, end of funnel and femoral isthmus, were measured, the mean of the ratio from frontal and lateral X-ray were designated as R. We classified the data into a high matching group (R is less than the median) and a low matching group (R is greater than or equal to the median) within each layer, and compared total blood loss, hidden blood loss and overt blood loss between the two groups. Hidden blood loss, as dependent variable, and age, fracture type and R, as independent variables were analyzed by using multiple linear regression. Results The hidden blood loss and total blood loss in the high matching group were significantly less than that in the low matching group on three layers (P＜0.05）, however, there was no significant difference of overt blood loss. Only R values from start of funnel and end of funnel were correlated to hidden blood loss (P<0.05). Conclusion The higher matching rate of PFNA II at the funnel is，the less hidden blood loss and total blood loss will be. |
