Incidence and location of deep vein thrombosis of lower extremity following surgery of tibial plateau fracture
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20223449Keywords:
DVT, Tibial plateau fracture, UltrasoundAbstract
Background: Tibial plateau fractures are commonly seen fractures of lower limb. They are challenging to manage since they are mostly associated with soft tissue injuries. Deep vein thrombosis (DVT) is a significant cause of morbidity and pulmonary embolism can even cause mortality in all hospitalized patients, especially after trauma and lower extremity fracture, which further carries risk of significant morbidity and mortality. We aim to evaluate the epidemiological characteristics of postoperative DVT in tibial plateau fractures.
Method: A prospective observational randomized study was performed. A total of 79 patient were included in this study who had proximal tibia fractures. Pre-op ultrasonography was done and post operative ultrasonography was done following proximal tibia plating surgery on day 2. Successive evaluation with USG was done at week 2, week 3 and week 4 for DVT. If DVT is diagnosed it will be managed medically.
Result: A total of 79 patients were included in the study, 28 were females and 51 males. 4 out of 79 patients were diagnosed with DVT following surgery of tibial plateau fracture. Predominantly DVT was seen in male patient of elderly age group who had high energy trauma operated by open reduction with duration of surgery of more than 1 hour. 3 out of 4 patients had distal DVT and 1 had proximal DVT.
Conclusions: Six risk factors were found to be strongly associated with DVT i.e., old age, male gender, high energy trauma, increased preoperative interval, open reduction and prolonged duration of surgery. These epidemiologic data will be helpful in individual assessment, risk categorisation and development of targeted prevention programs.
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References
Zhang Y. Clinical epidemiology of orthopedic trauma. 2nd edi, Thieme. 2012.
Lapidus LJ, Rosfors S, Ponzer S, Levander C, Elvin A, Lärfars G et a. Prolonged thromboprophylaxis with dalteparin after surgical treatment of achilles tendon rupture: a randomized, placebo-controlled study. J Orthopaedic Trauma. 2012;21(1):52-7.
Lapidus JL, Ponzer S, Elvin A, Levander C, Larfars G, Rosfors S et al. Prolonged thromboprophylaxis with Dalteparin during immobilization after ankle fracture surgery: a randomized placebo-controlled, double-blind study. Acta Orthopaedica. 2007;78(4):528-35.
Gaston P, Will EM, Keating JF. Recovery of knee function following fracture of the tibial plateau. J Bone Joint Surg Br Vol. 2005;87(9):1233-6.
Gardner MJ, Yacoubian S, Geller D. Prediction of soft-tissue injuries in Schatzker II tibial plateau fractures based on measurements of plain radiographs. J Trauma. 2006;60(2):319-23.
Stevens DG, Beharry R, McKee MD. The long-term functional outcome of operatively treated tibial plateau fractures. J Orthop Trauma. 2001;15(5):312-20.
Houben PF, Van der Linden ES, Van den Wildenberg FA. Functional and radiological outcome after intra-articular tibial plateau fractures. Injury. 1997;28(7):459-62.
Li J, Zhu Y, Chen W, Zhao K, Zhang J, Meng H et al. Incidence and locations of deep venous thrombosis of the lower extremity following surgeries of tibial plateau fractures: a prospective cohort study. J Orthop Surg Res. 2020;15(1):605.
Calfon M, Seddighzadeh A, Piazza G, Goldhaber SZ. Deep vein thrombosis in orthopedic surgery. Clin Appl Thromb Hemost. 2009;15(5):512-6.
Choufani C, Aguir S, Barbier O. Thromboembolic risk in repatriated patients with traumatic lower-limb injuries. J Med Vasc. 2018;43(6):342-6.
Zhu et al. Incidence and locations of preoperative deep venous thrombosis (DVT) of lower extremity following tibial plateau fractures: a prospective cohort study. J Orthop Surg Res. 2021;16:113.