Does the Surgical Approach Influence Bleeding in Hip Fracture Patients Taking Clopidogrel?

Background The aim of this study was to evaluate the effect of the choice of approach on bleeding in patients with femoral neck fractures who are on clopidogrel. Materials and methods The study included patients over the age of 60 who were taking clopidogrel and had hemiarthroplasty surgery for a femoral neck fracture. A total number of 61 patients were evaluated in the study. Patients who underwent surgery using the posterior approach were assigned to group 1, while those who underwent surgery using the anterolateral approach were assigned to group 2. Preoperative and postoperative hemoglobin levels, transfusion needs, red blood cell (RBC) loss, duration of surgery, and the length of hospitalization were evaluated. Results The mean age of the patients was 79.36 ± 7.72 years. Twenty-nine patients were included in group 1 and 32 patients were included in group 2. There was no significant difference between the two groups in terms of gender, age, and comorbidities (p=0.74, p=0.12, p=0.23, respectively). There were no significant differences between group 1 and group 2 in terms of duration of surgery and length of hospital stay (p=0.41, p=0.37, respectively). Also, there was no significant difference in RBC loss between group 1 and group 2 (p=0.37). Conclusion The use of anterolateral or posterior approaches has no effect on bleeding in clopidogrel-treated patients having hemiarthroplasty for femoral neck fracture. The authors recommend surgeons choose the approach according to their experience and patients' needs.