Tranexamic Acid Use in Open Reduction and Internal Fixation of Fractures of the Pelvis, Acetabulum, and Proximal Femur: A Randomized Controlled Trial

Ninety-three adult patients with fractures of the pelvis, acetabulum or proximal femur and scheduled for an open reduction and internal fixation procedure were randomized to receive either 2 doses of peri-operative tranexamic acid (TXA) or no TXA administration. The primary outcomes of interest included total blood loss, the change in hematocrit and hemoglobin levels from baseline, and transfusion outcomes. Additional outcomes included the incidence of venous thromboembolism, estimated surgical blood loss and operative time. The findings from the trial revealed significantly favourable small blood loss and change in hematocrit from baseline at post-operative day 1 and 2 in the TXA group compared to the control group. No significant differences were observed between the TXA and control groups in the rate of transfusion, incidence of venous thromboembolism, operative time and estimated surgical blood loss. Hemoglobin levels were not reported.