Bone Fractures Of Lower Limbs Research Articles

Clinical Application and Evaluation of Specialised Ring Fixators for the Management of Upper and Lower Limb Bone Fractures in Dogs

Present study was conducted on nine-clinical cases of humerus (n=4), femur (n=3) and radius-ulna (n=2) fractures in dogs of either sex, weighing 5.5 to 18 kg. Both closed (n=6) and open (n=3) fractures were treated in this study. The fracture was reduced and stabilized by transfixation using modified ring fixators. Semicircular (n=4) and hybrid fixators (n=5) were used for upper limb and lower limb bones respectively. The main component of fixator i.e. aluminium rings were designed locally at Bikaner using 4-mm aluminium sheets and fabricated accordingly. Full rings were used for distal radial (n=2) and distal femoral (n=1) fractures whereas semicircular rings were made through cutting the full ring during surgery for specific humeral (n=4) and femoral (n=2) fractures. Specialised wire fixation bolt (iron based; weighing 5.5g) was also designed locally at Bikaner for transcortical pin and ring articulation. Humeral and distal femoral fractures are challenging while bone plating of distal radial fracture demands further surgeries therefore external fixators were modified and applied in present study. Operated limbs were evaluated clinically with serial postoperative radiographs at regular intervals. Fixator-assembly evaluation and functional recovery of operated limbs were considered as objectives of this study.

Bone Transport through Induced Membrane versus Conventional Bone Transport in Management of Infected long bone defects of Lower Limbs: a randomized controlled trial.

To compare bone transport through induced membrane (BTM) and conventional bone transport (BT) regarding docking site union and infection recurrence in management of infected long bone defects. prospective randomized controlled study. tertiary level center. 30 patients with infected non-united long bone fractures of lower limbs. 15 patients treated by BTM in group (A) and 15 patients treated by BT in group (B). External fixation time (EFT), External fixation index (EFI), Docking time (DT). Bone and functional outcomes evaluated by the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system. Postoperative complications evaluated according to Paley's classification. The mean docking time (DT) was significantly lower in BTM group in comparison to BT group (3.6 ± 0.82 months vs 4.8 ± 0.86 months respectively; P value 0.001). Docking site non-union and infection recurrence were significantly lower in BTM group in comparison to BT group (0% vs 40%; P value 0.02 and 0% vs 33.3%; P value 0.04 respectively) with no significant difference in EFI (P value 0.08). This is the first prospective randomized controlled study comparing BTM and BT techniques showing that BTM had significantly faster docking site union, lower incidence of postoperative complications including docking site non-union and infection recurrence rates and lower number of additional procedures needed at the expense of two staged operation in comparison to BT.

Influence of muscle loading on early-stage bone fracture healing

Designing weight-bearing exercises for patients with lower-limb bone fractures is challenging and requires a systematic approach that accounts for patient-specific loading conditions. However, ‘trial-and-error’ approaches are commonplace in clinical settings due to the lack of a fundamental understanding of the effect of weight-bearing exercises on the bone healing process. Whilst computational modelling has the potential to assist clinicians in designing effective patient-specific weight-bearing exercises, current models do not explicitly account for the effects of muscle loading, which could play an important role in mediating the mechanical microenvironment of a fracture site. We combined a fracture healing model involving a tibial fracture stabilised with a locking compression plate (LCP) with a detailed musculoskeletal model of the lower limb to determine interfragmentary strains in the vicinity of the fracture site during both full weight-bearing (100% body weight) and partial weight-bearing (50% body weight) standing. We found that muscle loading significantly altered model predictions of interfragmentary strains. For a fractured bone with a standard LCP configuration (bone-plate distance = 2 mm, working length = 30 mm) subject to full weight-bearing, the predicted strains at the near and far cortices were 23% and 11% higher when muscle loading was included compared to the case when muscle loading was omitted. The knee and ankle muscles accounted for 38% of the contact force exerted at the knee joint during quiet standing and contributed significantly to the strains calculated at the fracture site. Thus, models of bone fracture healing ought to account explicitly for the effects of muscle loading. Furthermore, the study indicated that LCP configuration parameters play a crucial role in influencing the fracture site microenvironment. The results highlighted the dominance of working length over bone-plate distance in controlling the flexibility of fracture sites stabilised with LCP devices.

Factors Determining the Functional and Radiological Outcome after Secondary Nailing in Open Fractures of Lower Extremity- A Prospective Cohort Study

Introduction: Open long bone fractures of lower limb are cumbersome to treat. Because of the increased chances of infection, wound debridement and external fixation is the primary procedure followed by a secondary intramedullary nailing when the wound improves. Pin tract infection, loss of fixation, non union is the most frequently encountered complications of external fixation. These complications have discouraged surgeons all over the world in accepting external fixation as a definitive method of fracture treatment. Secondary intramedullary interlocking nailing provides intramedullary input of cancellous tissue at the fracture site due to reaming and nailing. Aim: To evaluate the factors determining the outcome after secondary nailing in open fractures of lower extremity. Materials and Methods: The prospective cohort study was conducted from October 2017 to April 2020 at Pondicherry Institute of Medical Sciences, Pondicherry, India, 33 patients who had open long bone fractures of lower limb and underwent secondary nailing following external fixation, were evaluated. The patients were followed up for a period of six months. Factors such as age, bone involved, grade of injury, timing of debridement, time interval between external fixation and secondary nailing were analysed to see whether they affect the outcome of secondary nailing of open fractures of long bones. All patients underwent an initial thorough wound debridement and external fixation application. A secondary nailing was done once wound had settled down. Age, gender, bone involved, grade of injury, timing of debridement and timing of secondary nailing were noted for all the patients and patients were followed up at six weeks, three months and six months. Final functional outcome (end of six months) was calculated using Lower Extremity Functional Scale (LEFS) and radiological union (end of six months) was calculated using Radiological Union Scale in Tibial fractures score (RUST). Results: There were no statistically significant differences in RUST/LEFS score at the end of six months, with respect to age (p-value=0.825/0.847), gender (p-value=0.235/0.348), bone involvement (p-value=0.726/0.757), grade of injury (p-value=0.107/0.546) and timing of debridement (p-value=0.117/0.374). The mean RUST scores at six weeks, three months and six months were 4.39, 6.57 and 9.28, respectively. The mean LEFS scores at six weeks, three months and six months were 20.96, 34.92, 49.5, respectively. The radiological union rate in this study was 60.61% at the final follow-up. But patients who underwent secondary nailing with 10 days of primary debridement and external fixation had a statistically significant (p-value) better outcome in terms of RUST (p-value at 3 months=0.045)/LEFS (p-value at 6 months=0.030). Conclusion: The interval between external fixation and secondary nailing was found to be a significant determinant of radiological outcome at three months (p-value at 3 months=0.045) and better functional outcome at six months (p-value at 6 months=0.030) with patients undergoing secondary nailing within 10 days of external fixation having a good final outcome. However, the radiological outcome between the two groups was comparable at six months follow-up.

Relationship between the timing of debridement of open fractures of lower extremity and the incidence of surgical site infection

The optimal timing of debridement of open fractures has been a debatable topic for many years. The purpose of the present study was to evaluate the relationship between the timing of initial debridement and the development of subsequent infection in open long bone fractures of lower limb presenting to our institution. We did a retrospective cohort study in 89 cases of open long bone fractures of lower limb who had underwent wound debridement and fracture fixation. Patients were grouped as Group A (44 patients) in which debridement of open fractures were done within 12 hours of injury and Group B (45 patients) wherein debridement was carried out after 12 hours of injury. Out of 44 patients in group A, 21 patients had infection and 23 had no signs of infection at the end of 1 year. In group B, out of 45 patients, 19 were infected and 26 had no signs of infection at 1year follow-up. Statistical analysis showed that there was no significant relationship between the timing of debridement and infection rate (p value – 0.6). Hence open fractures can safely be debrided even after 12 hours of injury without increasing the chances of infection provided the antibiotics are started on time and the surgery is carried out by adequately rested and trained surgical team.

Structure of long bone fractures of lower limbs at a car injury

The most traumatized body region in road traffic accidents is the lower extremities, however, the structure of fractures has not been adequately studied. Objective: to study the structure of long bones fractures of the lower extremities in various nonlethal car injuries. Material and methods. The research material was 116 reports of primary forensic medical examinations of victims with fractures of the femur and/or shin bones resulting from a car injury. When studying the frequency of damage to various areas of the body and the frequency of fractures of long bones of the lower extremities, it was taken into account that 28 victims with polytrauma had multiple injuries, and thus 116 patients revealed 232 injuries of various areas of the body and 138 fractures of long bones of the lower legs. Research methods — retrospective analysis, descriptive statistics. Results. The main contingent of those injuries in the car accident was car drivers (8.5%) and pedestrians (47.3 %) aged 31–50 years. In the general group, the shin (37.9 %), thigh (21.6 %), head (13.8 %) were most injured areas, in the group of car drivers — neck, thigh, chest, shin, in the group of passengers — head, shin and thigh; pedestrians — shin, thigh, head. Due to the predominance of anterior (41.4 %) and anterolateral collisions of a moving car in the group as a whole, in cases of the of pedestrians injuries as well as in cases of in-cabin injuries, the presence of bumper fractures of the lower leg bones, as well as fractures of the femur of various localization, was observed. Conclusions. According to the initial forensic medical examination, a collision of a moving car with a pedestrian (78.4 %) and a collision of moving vehicles (21.6 %) were observed in the structure of non-lethal car accidents. In this case, diaphyseal fractures of the femur (29.8 %) and the shin bones (47.1 %) in the general group and in the group of pedestrians (20.4 and 40.7 %, respectively) predominated. Fractures of the femur of various localization were most often detected also in the in-cabin injuries (50.0 % of the total number of fractures in drivers and passengers).

Fat Embolism in Long Bone Fracture Patients and its Complications: A Prospective Study

Background: Incidence of fat embolism after long bone fracture in Indian scenario is not studied much. In our study we try to analyse data over 2 years to find incidence and its complications. Materials and Methods: Two hundred FES (fat embolism syndrome ) suspected patients secondary to long bone fractures admitted over a 1 year period included. Patients satisfying the clinical criteria proposed by Gurd and Wilson, and Schonfeld were included in the study. Clinical features, risk factors, complications and any sequelae were noted. Results: Out of 200 patient’s majority were male patients. Maximum (85.5%) cases were used immobilizers to stabilize case. Isolated fractures (97%) were more compare to multiple fracture (3%). Associated features included features of altered sensoriam (n = 14, 7%), petechial rash (6%), tachycardia (16.5%) and fever (14.5%). Hypoxemia was demonstrable in 25.5% (51patients) cases. Fat embolism was found in 2% (4 cases) study population. Hypoxia @ 72 hours more in multiple fractures (50%) compare to isolated fractures (4.6%). This association was statistically significant. (P<0.05) No long-term sequelae were observed. Conclusion: We conclude that in our representative population the incidence of fat embolism is slightly higher compared to other population. This amounts to 2% of people with long bone fractures of lower limb. Fat embolism was more in femur fractures compared to tibia fractures and the chance of fat embolism was more in multiple fractures when compared to isolated fractures. The incidence of fat embolism was more in closed fractures as compared to open fractures. Other salient features of the study were the increased incidence of fat embolism noted in fractures which were not immobilized. Key Words: Accidents; ARDS; Fat embolism syndrome; Fracture.

ПРИМЕНЕНИЕ КОМБИНИРОВАННОЙ ДВУХУРОВНЕВОЙ СПИНАЛЬНО-ЭПИДУРАЛЬНОЙ АНЕСТЕЗИИ С ФИКСАЦИЕЙ ЭПИДУРАЛЬНОГО КАТЕТЕРА В ПОДКОЖНОМ КАНАЛЕ С ИСПОЛЬЗОВАНИЕМ МОДИФИЦИРОВАННОЙ СПИННОМОЗГОВОЙ ИГЛЫ

The aim of the study is to assess the advantages of a new technique for conducting a combined two-level spinal-epidural anesthesia with fixation of an epidural catheter in the subcutaneous canal using a modified spinal needle among elderly and senile patients during operations for fracture of the lower extremity bones. Material . We analyzed 44 cases of combined two-level spinal-epidural anesthesia with epidural catheter fixation in the subcutaneous canal using a modified cerebrospinal needle in lower limb bone fracture surgeries among elderly and senile patients over 2019. The developed technique of combined two-level spinal-epidural anesthesia with fixation of the epidural catheter in the subcutaneous canal using a modified cerebrospinal needle made it possible to exclude cases of catheter migration by more than 1 cm and avoid development of local inflammatory reaction. Conclusion . Combined two-level spinal-epidural anesthesia with the fixation of an epidural catheter in the subcutaneous canal using a modified cerebrospinal needle is a reliable, effective and safe anesthesia technique for operations for hip fracture among elderly and senile patients and makes it possible to perform long-term postoperative analgesia without the risk of infectious complications and complications associated with dislocation of the epidural catheter.

Study of incidence and cause of delay for treatment of long bone fractures of the lower limb in tertiary care hospital

Background: Musculoskeletal trauma represents a considerable global health burden. Lower limb long bone fractures are seen as a serious concern at the individual and population level. So the purpose of the study was to find incidence and cause of delay for treatment of long bone fractures of the lower limb in tertiary care hospital.Methods: All adult patients (more than 18 years) reporting to Emergency Medicine Department of a tertiary care hospital with long bone fractures of lower limb were included in the study. Effects on the final outcome on the lifestyle of the patients were evaluated against the interventions and management at all stages of the course of the illness. Delay of surgery: in our study delay of surgery means if surgery occurs after one day (24 hours) of admission. The entire data is statistically analysed using SPSS software. P values less than 0.05 are considered to be statistically significant.Results: 74 operated cases. 60 cases (81.10%) had delayed surgery, 14 cases (18.9.0%) did not have delayed surgery. 33 cases (55%) had medical reason for delay, 19 cases (31.7%) had financial reason for delay, 5 cases (14.3%) had infrastructure issues (unit system/non availability of implant), 3 cases (5.0%) had plan of surgery as causes of delay.Conclusions: These factors have an effect in the final outcome of the cases. The final outcome is dependent on multiple factors. Adequate attention to each and every one of them was long way to get the patient to the pre-incident stage.

Clinical and radiological evaluation of minimally invasive intramedullary fixation by titanium elastic nails in paediatric long bone fractures of lower limb: a prospective study

<p class="abstract"><strong>Background:</strong> Elastic stable intramedullary nailing for the treatment of paediatric femur and tibial diaphyseal fractures was introduced by Prevot and colleagues in 1979. It follows three-point fixation principle that provides internal support in presence of cortical contact and an intact soft-tissue envelope. This technique has many advantages, including better reduction, dynamic axial stabilization, shorter hospitalization with early rehabilitation and low complication rate.</p><p class="abstract"><strong>Methods:</strong> This is a prospective observational study done at Kauvery Medical Centre, Trichy between May 2017 to May 2018 consisting of 39 children between age 5 to 16 years with diaphyseal fractures of femur and tibia. The fractures were treated by closed reduction and internal fixation with titanium elastic intramedullary nailing. The patients were evaluated clinically and radiologically and followed for an average of 6 months. Outcome was assessed using transcutaneous electrical nerve stimulation (TENS) scoring system used by Flynn et al.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our series consisted of 39 patients (22 cases with fracture shaft of femur and 17 cases with fracture shaft of tibia), 33 males and only 6 females. Average time for radiological union was 9.89 weeks. All patients had full range of hip and ankle motion and 2 (5.1%) patients had mild restriction in knee flexion at 12 weeks.</p><p class="abstract"><strong>Conclusions:</strong> Elastic stable intramedullary nailing is an ideal method for treatment of paediatric femoral and tibial diaphyseal fractures due to lower complication rate and good functional outcome in comparison to other methods of treatment.</p>

The effectiveness of ultrasound in the detection of fractures in adults with suspected upper or lower limb injury: a systematic review and subgroup meta-analysis

BackgroundThe aim of the present review is to assess the effectiveness of ultrasound (US) in the detection of upper and lower limb bone fractures in adults compared to a diagnostic gold standard available in secondary and tertiary care centres (e.g. radiography, CT scan or MRI).MethodsThe review followed PRISMA guidelines and used a database-specific search strategy with Medline, EMBASE and The Cochrane Library plus secondary sources (see supplementary material for completed PRISMA checklist). Diagnostic performance of ultrasound was assessed with a qualitative synthesis and a meta-analysis of two data subgroups.ResultsTwenty-six studies were included (n = 2360; fracture prevalence =5.3 % to 75.0%); data were organised into anatomical subgroups, two of which were subjected to meta-analysis. Sensitivity and specificity ranged from 42.11 − 100% and 65.0 − 100%, with the highest diagnostic accuracy in fractures of the foot and ankle. The pooled sensitivity and specificity of US was 0.93 and 0.92 for upper limb fractures (I2 = 54.7 % ; 66.3%), and 0.83 and 0.93 for lower limb fractures (I2 = 90.1 % ; 83.5%).ConclusionUltrasonography demonstrates good diagnostic accuracy in the detection of upper and lower limb bone fractures in adults, especially in fractures of the foot and ankle. This is supported by pooled analysis of upper and lower limb fracture subgroups. Further research in larger populations is necessary to validate and strengthen the quality of the available evidence prior to recommending US as a first-line imaging modality for prehospital use.Trial registrationThe protocol is registered with the PROSPERO International register of systematic reviews: ID = CRD42017053640.

Early Outcome of Culture-Negative Infection in Open Fractures of the Lower Limb: A Prospective Study

AbstractBackground: Culture-negative infections in open long bone fractures are frequently encountered in clinical practice. We aimed to identify the rate and outcome of culture-negative infections in open long bone fractures of lower limb. Methodology: A prospective cohort study was conducted from November 2015 to May 2017 on Gustilo and Anderson Grade III open long bone fractures of the lower limb. Demographic data, injury details, time from injury to receiving antibiotics and index surgical procedure were noted. Length of hospital stay, number of additional surgeries and occurrence of complications were also noted. Patients with infected open fractures were grouped as culture positive or culture negative depending on the isolation of infecting microorganisms in deep intraoperative specimen. The clinical outcome of these two groups was statistically analysed. Results: A total of 231 patients with 275 open fractures involving the femur, tibia or fibula were studied. There was clinical signs of infection in 84 patients (36.4%) with 99 fractures (36%). Forty-three patients (51.2%) had positive cultures and remaining 41 patients had negative cultures (48.8%). The rate of culture-negative infection in open type III long bone fractures in our study was 17.7%. There was no statistical difference in the clinical outcome between culture-negative and culture-positive infections. Conclusion: Failure to identify an infective microorganism in the presence of clinical signs of infection is routinely seen in open fractures and needs to be treated aggressively.

Организация специализированной хирургической помощи пациентам с около- и внутрисуставными переломами костей нижних конечностей

The aim of this work is to develop a system of surgical treatment of intra- and periarticular fractures of lower limb bones for improving the results and reducing the number of postoperative complications. Material and methods Short- and long term results of surgical treatment of 390 patients with periand intraarticular lower limb fractures treated at a trauma department 1 of hospital # 24 in the period between 2010 and 2014 were analyzed according to a similar schedule of requirements to recovery of anatomic and functional parameters of the hip, knee and ankle joint. There were 198 men (50.8 %) and192women (49.2 %). Radiological, clinical and statistical research methods were used. Statistical methods included estimation of significance of differences for parametric and non-parametric criteria, assessment of the relationship signs on the Pearson’s coefficient of linear correlation. To study the results of hip treatment the Harris Hip Score (H. W. Harris, 1969) was used, in the region of the knee – P. S. Rasmussen scale (1973), and in the ankle – of E. Mazur (2006) which include subjective and objective criteria. Results Good functional outcomes were obtained in 87.1 % of femoral neck fractures, in extra-articular fractures of the proximal femur– in 76.2 %, in intra-articular fractures of the distal femur – in 75.0 %, intra-articular fractures of the proximal tibia - in 78.3 %, intra-articular fractures of the distal tibia in 96.6 % of cases. Conclusion Implementation in the clinical practice of the system of surgical treatment of peri- and intraarticular fractures, including improved diagnostics, practical orientation of injury systematization, algorithms for clinical diagnostic search, consecutive use of external and internal osteosynthesis, rational technique of joint arthroplasty, new technologies of osteosynthesis with a differentiated choice of metal fixators, a modified proximal femoral metal fixator, approaches to joints, methods for bone defect plasty; all these factors combined with the method of perioperative management of patients and early active rehabilitation achieved the prevalence of excellent and good anatomical and functional results for each studied location of injurie in main subgroups in comparison with the control ones.

Deaths Due to Pulmonary Embolism: 2 Case Reports

Pulmonary embolism (PE) is a major cause for morbidity and mortality. Following trauma to lower extremities, thrombus formation is a well-know entity, and one needs to foresee the possibility of embolism and eventual death. It is imperative and the onus solely rests on the treating doctor to weigh the risk factors for thrombus formation like age, sex, obesity, fracture, and immobilization and take necessary precautions to prevent pulmonary embolization. Two such cases with fractures of lower limb bones, where the deceased were middle aged, obese and immobilized for a period of time, died following muscular activity and autopsy revealed PE.

NEW APPROACH TO SOLVING THE PROBLEM OF COMPLEX REGIONAL PAIN SYNDROME

Aim - to improve the results of treatment of patients with complex regional pain syndrome (CRPS) in bone fractures of the lower extremities by applying a new integrated approach. Methods. A new approach to solving the problem of complex regional pain syndrome in fractures of lower limb bones is proposed, including the use of modern minimally invasive methods for surgical treatment of fractures of the lower limb bones, such as blocked osteosynthesis, Fixion technology, use of angular stability plates, metal structures for osteosynthesis of the proximal femur. All these measures help to minimize the negative effect that is produced on the bone by such factors as prolonged immobilization and absence of early movements of the joints, which will make it possible to perform CRPS prophylaxis in bone fractures of the lower limbs more effectively. If it is not possible to prevent the development of CRPS, then it is necessary to administer complex therapy, including psychoemotional correction, adherence to the regime, proper immobilization, rehabilitation exercises, physiotherapy, medical treatment, hyperbaric oxygenation, and gravitational therapy. Results. Clinical tests, radiography, densitometry, method of statistical analysis and mathematical modeling with elements of evidencebased medicine objectively confirmed the activation of the restorative processes in altered tissues of the lower limbs due to the use of the new complex. Conclusion. The analysis of the obtained data of clinical and functional methods of research has proved that the total value of positive results is 80%.

Comparison of Two Techniques of Reaming for Delayed-Union Long Bone Fractures of Lower Limb

Comparison of Two Techniques of Reaming for Delayed-Union Long Bone Fractures of Lower Limb

Refractory rheumatic disorder: atypical postpregnancy osteoporosis.

This is a case report on a young patient with severe osteoporosis that was initially revealed when she presented with polyarthralgia during her second pregnancy. Postpartum, the pain increased and her X-ray did not show any abnormalities. A bone scintigraphy was performed. It indicated an inflammatory rheumatic disorder. Six months after partum, an investigation of right coxalgia revealed a spontaneous basicervical fracture. Given the persistent polyarthralgia, the patient underwent a new scintigraphy, which revealed areas of what looked to be old rib and L1 fractures. A subsequent full body magnetic resonance imaging (MRI) scan revealed signal abnormalities that could indicate multiple lower limb bone fractures. Despite exhaustive biological, radiological, and histological testing, no secondary cause for the osteoporosis was found. The patient was started on teriparatide. We finally concluded that, despite the atypical presentation, the patient was suffering from postpregnancy osteoporosis. It is possible that the frequency of occurrence of this still poorly understood disease is underestimated.

A single-center retrospective study on the intraluminal implantation of inferior vena cava filter for the lower extremity trauma patients with deep venous thrombosis

To evaluate the application of inferior vena cava filter (IVCF) in prevention of peri-operative pulmonary embolism (PE) in lower limb bone fracture patients with deep venous thrombosis (DVT). From January 2003 to December 2012, 2 248 cases of lower limb and pelvic fractures with DVT were retrospectively analyzed. Before the procedure of IVCF implantation began, January 2003 to December 2007, there were 1 052 cases of acute trauma patients with DVT were classified as the group of early none-IVCF. The IVCF implantation was began since January 2008. From that time to December 2012, 712 cases of bone fractures with DVT received filter implantation, which were classified as IVCF group. The other 484 patients who had not undergone filter deployment were divided as group of late none-IVCF. The baseline conditions of the three groups were significantly different in addition to the ages between group of early none-IVCF and IVCF group. The incidences of PE and mortality of PE in each group were recorded and analyzed by χ(2) test. There were totally 31 cases of symptomatic PE, among which 12 cases died. Totally 712 filters were deployed successfully without any major complications. The incidences of symptomatic PE were 0.14% (1/712), 2.19% (23/1 052) and 1.45% (7/484) in IVCF group, group of early none-IVCF and group of late none-IVCF, respectively. The mortality of PE were 0 (0/712), 0.86% (9/1 052) and 0.62% (3/484) in these groups. The incidence of symptomatic PE in IVCF group was significantly different from that in the group of early and late none-IVCF (χ(2) = 11.762, P = 0.001; χ(2) = 7.395, P = 0.007, respectively). The mortality of IVCF group was also significantly lower compared with the other two groups (χ(2) = 6.122, P = 0.013; χ(2) = 4.424, P = 0.035, respectively). IVCF implantation effectively prevents symptomatic and fatal PE of patients of lower limb and pelvic fractures with DVT in the peri-operative period.