Guo J, Zhang Y, Hou Z, et al. - The present study was conducted to examine whether intramedullary fixation does not cause a large amount of hidden blood loss in elderly patients with intertrochanteric fractures. Researchers designed a retrospective cohort study including a total of 1,017 consecutive patients aged ≥ 65 years with acute intertrochanteric fractures. Between July 2013 and January 2018, individuals were allocated into three groups (non-operative group, delayed surgery group, and acute surgery group). They obtained and compared data of patient's demographics, injury-related data, operation-related data, comorbidities, perioperative hemoglobin values, transfusion data, and serial of hidden blood loss (HBL) calculated during hospitalization among three groups. The outcomes of this study illustrate that HBL is the main component of total blood loss and it is more likely to result from the initial trauma rather than the surgery. The findings revealed that intertrochanteric fracture treated by intramedullary fixation does not cause a large amount of HBL.