Ravindra Bhalchandra Gunaki1, Rupesh Arvinbhai Gor2, Jimit Deepak Shah3, Vaibhav Jagnath Koli4, Sudeep Umesh Date5
It is a well-known fact that significant blood loss occurs after long bone reaming in intramedullary nailing. Still, limited research has been done to evaluate the blood loss after specific amount of reaming. In this study, we have tried to evaluate the same.
MATERIALS AND METHODS
It is a combined retrospective and prospective comparative study. Data of 240 patients having isolated shaft of femur fractures (100 cases), isolated shaft of tibia fractures (100 cases) & ipsilateral or contralateral femur + tibia fractures (24 cases), treated with reamed interlocking intramedullary nails and within the age group of 20-60 years was collected. Haemoglobin and PCV values on the day of operation and values after 24 hours after the procedure were noted as parameter for blood loss. Reaming was started from 8.5 mm and done up to chatter sound heard while reaming. Cases with open fractures, patients with blood disorder to whom intra or post-operative blood transfusion was given, were excluded. Fracture union was evaluated from radiographs taken at every 4 weeks’ interval.
It was found that post-operative haemoglobin levels were low as compared to pre-operative values, which was statistically significant (p value <0.0001). The loss of haemoglobin was not influenced by factors like age, sex, side. The mean loss of haemoglobin was 2.75 g%. The mean union time was 18.11 weeks.
We conclude from the results obtained there is significant correlation between reaming and volume of blood loss. It was observed that as there is increase in diameter of reaming of medullary canal of bone; blood loss also increases proportionately.