Comparative efficacy of intravenous, topical, and combined tranexamic acid in elderly patients with intertrochanteric fractures undergoing intramedullary nail fixation: a multicenter cohort study

In older adults undergoing intramedullary fixation for intertrochanteric fractures, TXA reduces blood loss without increasing complications, with greatest benefit from combined intravenous plus topical use. These findings support TXA as a key component of perioperative blood management in this population.