Incidence of deep venous thrombosis after temporary joint spanning external fixation for complex tibia plateau injury

Abstract

Objective To discuss whether the cross-joint external fixator increased the incidence of deep venous thromboembolism (DVT) in severe tibial plateau fractures caused by high energy injury.Methods We retrospectively studied 55 cases of severe tibial plateau fracture (AO type C) that had been treated in our hospital from January 2010 to December 2011.We divided them into 2 groups according to the temporary fixation.In study group,the emergency cross-joint external fixators were applied and in the control group plaster immobilization was applied.The study group had 16 males and 6 females with an average age of 44.2 years while the control group had 26 males and 7 females with an average age of 42.2 yeas.Color Doppler examination of the lower limb was conducted in all patients before definite internal fixation.Phlebography of the lower limb was performed in suspected DVT cases.Incidences of DVT in the 2 groups were compared before the definite internal fixation.Results Seven cases (4 proximal and 3 distal ones) in the study group and 9 cases (5 proximal and 4 distal ones) in the control group were found to develop DVT.There was no significant difference between the 2 groups in the DVT incidences (31.8％ vs.27.3％) (x2 =1.320,P =0.716).There was no significant difference between the 2 groups either in the proximal DVT incidences (18.2％ vs.15.2％) (x2=0.886,P=0.766).The DVT cases found in the 2 groups were all asymptomatic; the time of DVT onset was 7.6 ± 1.7 days after initial injury in the study group and 5.2 ± 2.8 days in the control group.Conclusion In the staged treatment of severe tibial plateau fractures,compared with plaster immobilization,the temporary cross-joint external fixator will not increase the incidence of DVT before the definite internal fixation. Key words: Lower extremity; Tibial fracture; External fixation; Venous thromboembolism