From the Guidelines
A platelet count of 50,000/mL is generally considered sufficient for ORIF and plating in a patient with distal humerus fracture.
Rationale
- The American Society of Clinical Oncology suggests that a platelet count of 40,000/mL to 50,000/mL is sufficient to perform major invasive procedures with safety, in the absence of associated coagulation abnormalities 1.
- A retrospective review of 167 operations in 95 patients with acute leukemia found that preoperative platelet transfusions to achieve platelet counts of greater than 50,000/mL resulted in no deaths caused by surgery-related hemorrhage and minimal intraoperative blood loss 1.
- While there are sparse data about the safety of other invasive procedures at much lower count levels, a platelet count of 50,000/mL is often stated as a standard for the level at which major surgery can be performed safely 1.
Key Considerations
- The presence of concurrent coagulation abnormalities may increase the risk of significant bleeding, and platelet transfusions should be available on short notice in case intraoperative or postoperative bleeding occurs 1.
- For alloimmunized patients, histocompatible platelets must be available in these circumstances 1.
- It is critical that a posttransfusion platelet count be obtained to prove that the desired platelet count level has been reached if platelet transfusions are administered before a procedure 1.
From the Research
Platelet Count Cutoff for ORIF and Plating in Distal Humerus Fracture
- There is no specific information provided in the given studies regarding the platelet count cutoff for ORIF (Open Reduction Internal Fixation) and plating in a patient with distal humerus fracture.
- The studies primarily focus on the outcomes, complications, and management of distal humerus fractures using ORIF with various plating techniques 2, 3, 4, 5.
- One study discusses the management of proximal humerus fractures using locking plates, but does not provide information on platelet count cutoff 6.
- None of the studies mention the platelet count as a factor in the decision-making process for ORIF and plating in distal humerus fractures.
Relevant Findings
- The studies suggest that ORIF with anatomical locking plates can provide good functional outcomes and low complication rates in patients with distal humerus fractures 3, 4.
- The choice of plating technique, such as parallel or perpendicular plating, can affect the outcome and complication rate 2.
- Early mobilization and stable fixation are important for achieving good outcomes in patients with distal humerus fractures 4, 5.