Relationship between the incidence of deep vein thrombosis during hospitalization and the energy of injury in tibial plateau fractures

Abstract

Objective To investigate the relationship between the incidence of deep vein thrombosis (DVT) during hospitalization and the energy of injury in tibial plateau fractures(TPFs). Methods 140 patients were enrolled in the study between September, 2014, and October, 2017 in Honghui Hospital, Xi′an Jiaotong University. According to the Schatzker classification, the low-energy group (Schatzker Ⅰ-Ⅲ) X-ray showed a simple or lateral fracture or compression fracture of the lateral plateau (n=63); the high-energy group (Schatzker Ⅳ-Ⅵ) X-ray showed the medial tibia or double of the tibial plateau (n=77). Duplex Ultrasonography was performed in lower extremities before and after surgical intervention for DVT evaluation and record the incidence of DVT, the days during hospitalization, the blood loss during surgery and the level of D-Dimer. All patients received mechanical and chemical thromboprophylaxis. The patient was followed up for one month after surgery, and the lower extremity ultrasound was reviewed and recorded. The measurement data were expressed as (±s), and the categorical variables were expressed in composition ratio. The measurement data were all in accordance with the normal distribution and the variance was uniform. The t-test was used, and the Chi-square test was used for comparison between groups. Results The incidence of thrombosis of tibial plateau fracture in TPFs was 36.43% and 46.43% pre-operation and post-operation respectively. The thrombosis incidence was 31.75%(20/63) in the low-energy group and 40.26%(31/77) in the high-energy group pre-operation. The thrombosis incidence was 44.44%(28/63) in the low-energy group and 48.05% (37/77) in the high-energy group post-operation. Statistical analysis showed no significant difference between the two groups pre-operation (P=0.298) and post-operation(P=0.785). The days during hospitalization [(11.94±4.18) d, (9.56±2.54) d], the blood loss during surgery [(208.96±224.43) ml, (129.68±142.14) ml] and the level of D-Dimer [(2.39±3.38) mg/L, (1.21±2.32) mg/L]at pre-operation showed differences in the high energy group and the low energy group, respectively. Conclusions The incidence of DVT in TPFs is high during the hospital, but most of DVT is concentrated in the distal to the knee. Although the incidence of high energy injury and low energy injury DVT is not significantly different in TPFs, we should also be alert to the occurrence of DVT. Key words: Venous thrombosis; Tibial fractures; Ultrasonography, doppler; Low energy injury; High energy injury