Tranexamic acid is an antifibrinolytic drug that has been used to decrease post-operative blood loss. This study is a prospective, randomized controlled trial investigating the use of tranexamic acid in fracture surgery around the hip and knee, in which significant blood loss (>300mL) is expected.

The hypothesis of this study is that tranexamic acid will be associated with a decrease in post-operative blood loss, as well as a decreased need for allogenic blood transfusion, in patients who have fracture surgery around the hip and knee.

Inclusion Criteria:

• Patients with isolated fractures of the pelvic ring, acetabulum, femur or tibia that will require open reduction and internal fixation
• Expected blood loss is greater than 300 mL
• Age ≥ 18
• Skeletal maturity

Exclusion Criteria:

• Pregnant or breastfeeding
• Patients taking oral contraceptives
• Contraindication to venous thromboembolic event (VTE) prophylaxis (intracranial, intrathoracic, intra-abdominal bleeding or spine fractures)
• Patients requiring operative intervention for other injuries (orthopaedic or non-orthopaedic)
• Known hypercoagulable state including history of prescribed anti-coagulation (warfarin, plavix, low molecular weight heparin)
• Renal Insufficiency (creatinine greater than 1.5mg/dL)
• Open fractures