A cross-matching policy for fractures of the proximal third of the femur.

Cross-matching and transfusion policies for patients with a fracture of the proximal third of the femur are poorly formulated. A series of 90 patients who underwent operation for such fractures at a district general hospital were evaluated. Unnecessary cross-matching was most frequent in intracapsular fractures, and discrepancies in indications for postoperative transfusions were demonstrated. If postoperative transfusion is indicated for haemoglobin levels of less than 9 g/dl, we recommend routine preoperative cross-matching only for patients admitted with trochanteric fractures and haemoglobin levels between 10 and 12 g/dl. This practice is safe and is a potential area for savings in cost and resources.