The clinical value of bedside ultrasound in the screening of perioperative lower extremity deep vein thrombosis in elderly patients with femoral neck fracture

Yao Yao ,Zhiming Jiang ,Jin Dai ,Dongyang Chen ,Junlan Qiu ,Xu Zhang ,Chengyan Zhu ,Yi Shen ,Dongquan Shi ,Yexian Wang ,Liang Qiao ,Weiwei Zhang ,Qing Jiang

doi:10.3877/cma.j.issn.2096-0263.2018.02.002

Abstract

Objective To investigate the clinical value of bedside ultrasound in detection of deep vein thrombosis in elderly patients with femoral neck fracture. Methods A retrospective study was performed in patients with femoral neck fractures who underwent bilateral ultrasound in department of Sports Medicine and Adult Reconstructive Surgery of Drum Tower Hospital Affiliated to Medical School of Nanjing University from January 2016 to March 2017. The diameter of blood vessel, location, echo and blood flow were evaluated. Postoperative ultrasound were conducted routinely during hospitalization and after discharge. Results A total of 135 patients were enrolled in this study. There were 45 males and 90 females. The average age was 76±8 years old and the average body mass index was 22±3 kg/m2. Forty-five cases were diagnosed DVT. Seven cases were proximal DVT and thirty eight were distal. According to the anatomical location, one located in the iliac vein, four located in the femoral veins, four located in the popliteal veins, five cases located in the peroneal veins and three cases located in the posterior tibia veins, forty one cases located in the muscular vein. Surgeries were postponed in 13 DVT patients and all of them received thrombosis treatment and ultrasound screening every other day. Results showed that 10 cases were significantly improved, two cases had no improvement and one case aggravated, two cases received inferior vena cava filters. During postoperative screening, three preoperative DVTs were found to progress into other veins and all of them received treatment and the follow-up screening showed that no DVT failed off and no pulmonary embolism happened. Conclusion Bedside ultrasound can be used in the diagnosis, monitoring and follow up of DVT in patients with femoral neck fracture. Key words: Thrombosis; Ultrasonography; Femoral neck fractures; Arthroplasty, replacement, hip

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