Proximal femoral nail antirotation fixation for osteoporotic intertrochanteric fracture in the elderly: characteristics of deep venous thrombosis of lower extremity

doi:10.3969/j.issn.2095-4344.2016.35.008

Abstract

Abstract:

BACKGROUND: The risk of lower-extremity deep venous thrombosis was high in patients with the osteoporotic hip fracture. The aged age and hip fracture surgery are major risk factors for thrombosis. No study concerned the critical point in time course to the lower extremity deep venous thrombosis in the osteoporotic hip fracture patients.

OBJECTIVE: To analyze the incidence of the perioperative deep venous thrombosis of lower extremity limb at different time slots in senile osteoporotic intertrochanteric fracture patients repaired by proximal femoral nail antirotation fixation.

METHODS: From June 2012 to January 2016, 220 cases diagnosed as osteoporotic intertrochanteric fracture and performed closed reduction and proximal femoral nail antirotation fixation were selected from the Department of Orthopedics, the Affiliated Hospital of Chengde Medical College in China. Based on administered low-molecular-weight heparins (LMWH) or not after trauma, there were two groups: LMWH group and the non-LMWH group. Vascular Doppler ultrasound was conducted at 1, 3 and 5 days after trauma, more than 5 days after trauma, 2, 5, 7 and 14 days after surgery. The total number of cases and incidence of thrombosis were recorded and compared between the two groups. The number of cases and the incidence of new thrombosis were recorded at different time points in both groups. Frequency distribution table was used to analyze the time of suffering thrombosis after injury and surgery.

RESULTS AND CONCLUSION: (1) Among 220 cases, 18 cases in the LMWH group (n=154) affected thrombosis, with an incidence of 12%, and 15 cases in the non-LMWH group (n=66) experienced deep vein thrombosis, with an incidence of 23%. Significant differences in the incidence of thrombosis were detected between the two groups (P=0.041). (2) Peak time of thrombus was 3 days before injury and 1 day after surgery in both groups. (3) Results suggested that the incidence of deep vein thrombosis was high in proximal femoral nail antirotation fixation for intertrochanteric fracture. The peak time of deep vein thrombosis was 3 days before injury and 1 day after surgery. The prevention of deep vein thrombosis should begin from injury. Prophylactic anticoagulation after injury can dramatically decrease the incidence of deep vein thrombosis.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Femoral Fractures, Osteoporosis, Bone Nails, Venous Thrombosis, Tissue Engineering

CLC Number:

R318

Wei Jun-qiang, Liu Li-rui, Wang Xin-yu, Yan Shi, Jin Yu, Feng Zhen. Proximal femoral nail antirotation fixation for osteoporotic intertrochanteric fracture in the elderly: characteristics of deep venous thrombosis of lower extremity[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(35): 5224-5230.

Figures/Tables 3

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