Clinical Experiences with Tranexamic Acid for Open Reduction and Internal Fixation of Clavicle Fractures

Background and Objective: Open reduction and internal fixation of clavicle fractures is a common surgery and medications are considered to reduce intraoperative bleeding in this situation. This study aimed to observe the clinical effects of Tranexamic Acid (TXA) in open reduction and internal fixation of clavicle fractures. Materials and Methods: Forty-six patients who underwent open reduction and internal fixation of clavicle fractures were divided into two treatment groups. The observation group (n = 23) received an intravenous (IV) infusion of 0.8 mg TXA 0.5 hr before skin incision, an intraoperative topical injection of 1 mg TXA into the wound and a postoperative IV infusion of 0.8 mg TXA for 3 hrs. The control group (n = 23) did not receive any TXA treatment before, during, or after surgery. Patients in both groups were evaluated for the percentage decrease in red Blood Cell Count (RBC), Haemoglobin level (Hb) and Hematocrit (Hct) as well as the amount of total drainage within 72 hrs after surgery. All 46 patients were followed up and their complete data were collected. Results: Postoperatively, RBC, Hb and Hct levels in the observation group were similar to those in the control group, while the total postoperative drainage in the observation group was considerably lower than that in the control group. Conclusion: For open reduction and internal fixation of clavicle fractures, TXA was not significant in reducing total blood loss and haemoglobin drop but it had a significant reduction in mean postoperative total drainage and transfusion and did not increase the incidence of thrombosis and infection.