Objective  To investigate the efficacy and safety of tranexamic acid (TXA) in treatment of elderly patients with femoral intertrochanteric fracture by proximal femoral nail antirotation(PFNA).

  Methods  Seventy elderly patients with intertrochanteric fracture undergoing PFNA surgery were selected as the research subjects. According to whether TXA was used preoperatively, the patients were divided into control group and TXA group, with 35 cases in each group. TXA was not used preoperatively in the control group, while TXA was used preoperatively in the TXA group. The basic clinical data and blood loss of the two groups were analyzed, and the incidence of complications between the two groups was compared through follow-up.

  Results  The dominant blood loss, intraoperative blood loss, postoperative drainage volume, total blood loss and hidden blood loss in the TXA group were significantly less than those in the control group (P < 0.05). The blood transfusion rate and blood transfusion volume in the TXA group were significantly lower and less than those in the control group (P < 0.05). There were no significant differences in postoperative wound condition and incidence of complications between two groups (P>0.05).

  Conclusion  In the treatment of intertrochanteric fracture patients with PFNA intramedullary fixation, preoperative intravenous injection of 10 mg/kg TXA can effectively reduce the hidden blood loss and blood transfusion rate in elderly patients, and will not increase the risk of lower extremity deep vein thrombosis and pulmonary embolism, which is safe and effective.