The role of postoperative blood recovery for patients with femoral neck fracture.

Postoperative blood recovery in eighty elderly patients (11 male, 69 female) treated for femoral neck fracture was prospectively studied. Twenty-eight patients underwent hemiarthroplasty for intracapusular fracture and 52 underwent Dynamic Hip Screw fixation for extracapsular femoral neck fracture. The mean blood drainage in the postoperative period and the mean drop in haemoglobin level was higher in the DHS group as compared to the hemiarthroplasty group. Mean drainage in the first 6 postoperative hours was 150 ml (range: 10-450 ml) in the DHS group, versus 50 ml in the hemiarthroplasty group (range: 10-100 ml). Out of 52 cases of the dynamic hip screw fixation group, only 10 patients received autologous blood transfusion (19%), among which the drains collected more than 150 ml in only 4 (7%). The blood drainage in this group occurred in the first 6 hours only. Supplementary cross matched bank blood was transfused to patients in the DHS group (8%). Among 28 patients in the hemiarthroplasty group, only 6 patients received autologous blood reperfusion (21%), among which the drains collected more than 150 ml in only 4 (14%). Overall, only six patients out of 28 in the hemiarthroplasty and 10 out 52 in the DHS group had enough blood in their drains to warrant re-perfusion. We conclude that the routine use of Bellovac drains after femoral neck fracture surgery is not necessary and is not cost effective.