The Use of Tranexamic Acid in Hip and Pelvic Fracture Surgeries.

J Am Acad Orthop Surg · Jun 15 2021 · Review

Adams JD, Marshall WA

From the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (Adams)

Orthopaedic Trauma

SUMMARY — THE REDUCTIONTXA appears to reduce blood loss and transfusion needs in hip fracture surgery without added thromboembolic risk, but evidence is weaker for acetabular and pelvic ring fractures, warranting further study.
Abstract, as published

Tranexamic acid (TXA) use has expanded across many surgical specialties. It has been shown to reduce blood loss, decrease transfusion rates, and, in some cases, improve mortality. Within orthopaedic surgery, its popularity has primarily grown within arthroplasty and spinal surgery. It has only recently gained traction within the field of orthopaedic trauma and fracture care. At this time, most literature focuses on hip fracture and pelvic trauma surgery. For hip fractures, the results are encouraging and generally support the claim that TXA may lower overall blood loss and decrease transfusions. Conversely, less support exists for TXA use in fractures of the acetabulum or pelvic ring. Based on the current fracture-related studies, TXA does not seem to carry an increased risk of thromboembolism or other complications. In addition, few studies have been noted discussing the route of administration, timing, or dosage. This article reviews the most current literature regarding TXA use in fracture care and expands on the need for further research to evaluate the role of TXA in orthopaedic trauma populations who carry a high risk for transfusion.

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