Intravenous + Topical Tranexamic Acid for Intramedullary Nailing of the Tibia .
Medullary cavity application of tranexamic acid to reduce blood loss in tibial intramedullary nailing procedures-a randomized controlled trial.
Int Orthop. 2023 Aug; 47(8): 2095–2102.106 patients undergoing intramedullary nailing of the tibia were randomized to receive either intravenous (IV) + topical intramedullary tranexamic acid (TXA; n=51) or IV TXA alone with intramedullary saline (n=56). The primary outcomes of interest included total blood loss (TBL), hidden blood loss (HBL), and intraoperative blood loss (IBL). Secondary outcomes included C-reactive protein (CRP), interleukin-6 (IL-6), serum D-dimer, and the incident of thrombotic events. TBL, HBL, CRP, and IL-6 levels were significantly better in the IV + topical TXA group compared to IV TXA alone. Thrombotic events were similar between the two groups.
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