Abstract
BackgroundTo observe the outcome of isolated calf muscle vein thrombosis (ICMVT) undergoing open reduction and internal fixation (ORIF) for closed intra-articular distal femur fractures (DFFs) and to analyze related factors.MethodsThe study was designed as a prospective clinical cohort study at our hospital. From August 2018 to August 2020,a total of 140 patients with flesh ICMVT after ORIF for closed intra-articular DFFs were collected during hospitalization. After the administration of antithrombotic agents immediately after diagnosis, the location and prognosis of postoperative ICMVT were examined by Duplex ultrasonography (DUS) with a three-month follow-up. There were 29 males and 111 females with the average age of 70.16 ± 8.75 years old. Sonography was used to evaluate the resolution of muscular vein thrombosis at the time point of the third month postoperatively and the results were compared between the two time points. Multivariable analysis was performed to evaluate the relationship between the resolution of ICMVT three months postoperatively and risk factors including age, Body Mass Index (BMI), gender, thrombosis length (> 5 / ≤5 cm), thrombosis diameter(> 0.6/≤0.6 cm), and thrombosis-related biochemistry indices.ResultsThe postoperative ICMVTs was diagnosed at 5.47 ± 2.46 days after ORIF for closed intra-articular DFFs. At the follow up of 3 months,120 cases was tending to disappear with 88 cases(62.9 %) completely dissolved and 32 cases(22.9 %) partly dissolved. There existed 14 cases (10.0 %) without change on the size and 6 cases (4.2 %) with proximal propagation. Multivariate analysis revealed that thrombus diameter over 0.6 cm (odds ratio [OR], 8.900; 95 % confidence interval [CI]: 3.623–21.865), thrombus length over 5.0 cm (OR, 3.904; 95 % CI, 1.121–13.603), FIB over 3.0 g/L (OR, 3.627; 95 % CI, 1.356–9.689), and D-dimer over 1.0 mg/L (OR, 2.602; 95 % CI, 1.075–6.296) were four independent risk factors of non-completely dissolved ICMVTs.Conclusions85.8 % of ICMVT was tending to disappear at the third months after ORIF for closed intra-articular DFFs. Thrombus diameter, thrombus length, FIB, and D-dimer were four independent risk factors of non-completely dissolved ICMVTs. The Thrombus diameter has a significant effect on the natural course of ICMVTs, especially with diameter larger than 0.6 cm.
Highlights
To observe the outcome of isolated calf muscle vein thrombosis (ICMVT) undergoing open reduction and internal fixation (ORIF) for closed intra-articular distal femur fractures (DFFs) and to analyze related factors
A vascular laboratory studies of 406 patients with ICMVT indicated that isolated gastrocnemius and soleus vein thrombosis (VTE) was associated with a clinically significant rate of venous thromboembolism which was dramatically reduced with therapeutic anticoagulation [6]
Study design The present study, which was conducted at our hospital, is a prospective single-center study involving a total of 140 patients with flesh ICMVT after ORIF for closed intraarticular DFFs
Summary
To observe the outcome of isolated calf muscle vein thrombosis (ICMVT) undergoing open reduction and internal fixation (ORIF) for closed intra-articular distal femur fractures (DFFs) and to analyze related factors. The role of isolated calf muscle vein thrombosis (ICMVT) remains controversial [4]. Most of the ICMVT gradually disappear, but there remains a proportion of the ICMVT progressing rapidly to deep venous thrombosis (DVT) or pulmonary embolism (PE) [5]. A vascular laboratory studies of 406 patients with ICMVT indicated that isolated gastrocnemius and soleus vein thrombosis (VTE) was associated with a clinically significant rate of venous thromboembolism which was dramatically reduced with therapeutic anticoagulation [6]. The treatment of acute ICMVT needed to be standardized because no guidelines currently existed [7]
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