Reduction of postoperative bleeding following operative treatment of proximal humerus fractures using a collagen sponge

Aim of the present study is to investigate the efficacy and safety of TachoSil to reduce afterbleeding and hematoma following operative treatment of proximal humerus fractures. In a prospective randomized study we included a consecutive series of 40 patients with a proximal humeral fracture in this study. All fractures were stabilized surgically with a fixed-angle “Philos plate” from May 2008 through May 2009. All patients were divided in two groups: Group I with plate osteosynthesis without TachoSil, Group II with plate osteosynthesis with TachoSil. For statistical analysis Chi-Test and U-Test were used. There were 4 perioperative complications in group II and one complication in group I (Chi-Test: p = 0.233). In group II one hardware failure occurred due to osteoporosis requiring revision and reosteosynthesis. Another patient suffered from paralysis of the radial nerve which healed uneventfully. One superficial postoperative infection and one superficial hematoma required revision surgery, too. In this group no subfascial hematoma developed. One subfascial hematoma which required no revision occurred in group I. Blood transfusion was required 2 times in group I and 3 times in group II (Chi-Test: p = 0.549). In sum in group II there was a significant lower blood loss for the subfascial drain, the region where TachoSil was applied. No adverse affects related to TachoSil could be detected. TachoSil was found to be safe and effective for reduction of postoperative bleeding following operative treatment of proximal humerus fractures. Further studies with larger sample size are required to confirm the efficacy of TachoSil in orthopedic surgery.