Incidence of deep venous thrombosis in elderly patients with femoral neck fracture before arthroplasty

Abstract

Objective To report the incidence of deep venous thrombosis (DVT) in elderly patients with femoral neck fracture before arthroplasty. Methods From January 2007 to September 2007, 175 (51 male and 124 female) elderly patients with femoral neck fracture of Garden type Ⅲ or Ⅳ were admitted in our department. They had a median age of 73.5 years (range, 60 to 90 years). At different time points before hip arthroplasty, they had venous color Doppler ultrasonography in their bilateral lower limbs to screen DVT.The main ultrasonic criterion for diagnosis of DVT was the failure of the vascular lumen to collapse under the probe pressure. All the DVT-related data were collected. Results The mean interval from fracture to ultrasonography was 4.6 days (range, 3 to 6 days) for all but 6 patients who had much delayed medical attention (＞ 2 weeks). In this series the overall incidence of DVT was 18. 3% (32/175). The DVT incidence for patients examined from 3 to 6 days after fracture was respectively 13. 3% (4/30), 20.4% (10/49),19. 6% (10/51), and 17.9% (7/39), but dropped to 16. 7% (1/6) for those examined over 6 days after fracture. The incidence of DVT was 17. 6% (9/51) in men and 18.5% (23/124) in women. The DVT occurrence was 15. 7% (8/51) in patients aged 60 to 69 years, 18. 7% (17/91) in those aged 70 to 79 years and 21.2% (7/33) in those aged over 80 years. No statistically significant deference was found to be associated with interval from fracture to ultrasonography, age and gender in this study(P ＞ 0. 05). Conclusions The elderly patients with femoral neck fracture may have a high incidence of DVT before arthroplasty. For patients who are to have arthroplasty beyond 48 hours after fracture, ultrasonography should be performed to detect DVT in the lower limbs and prophylaxis should be taken to reduce their perioperative risk. Key words: Venous thrombosis; Femoral neck fractures; Doppler ultrasound