Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;142(2):247-253.
doi: 10.1007/s00402-020-03685-z. Epub 2020 Nov 21.

Incidence and risk factors of preoperative deep venous thrombosis in closed tibial shaft fracture: a prospective cohort study

Jiangtao Ma #  1   2   3 , Jin Qin #  1   2   3 , Meishuang Shang  1   2   3 , Yali Zhou  1   2   3 , Yingze Zhang  4   5   6   7 , Yanbin Zhu  8   9   10
Affiliations

Incidence and risk factors of preoperative deep venous thrombosis in closed tibial shaft fracture: a prospective cohort study

Jiangtao Ma et al. Arch Orthop Trauma Surg. 2022 Feb.

Abstract

Objective: To investigate the preoperative morbidity of deep venous thrombosis (DVT) and predictive risk factors associated with DVT after closed tibial shaft fracture.

Methods: Ultrasonography and blood analyses were performed preoperatively in patients who sustained tibial shaft fracture between October 2014 and December 2018. Univariate analyses were used in the data of demographics, comorbidities, mechanism of injury, concomitant fractures and laboratory biomarkers. Multivariate logistic regression analyses were conducted to determine the independent risk factors associated with DVT.

Results: In total, 918 patients with an operatively treated tibial shaft fracture were included, among whom 122 patients had preoperative DVTs, indicating a crude morbidity of 13.3%. Ninety-two of 758 (12.1%) patients with isolated tibial shaft fracture developed DVT, while 30 of 160 (18.8%) patients with concurrent fracture presented with DVT. The average interval between fracture and initial diagnosis of DVT was 3.1 days (median, 2 days), ranging from 0 to 33 days. Among DVT-positive patients, 16 (13.1%) patients presented with proximal DVT and 106 (86.9%) patients had distal DVT. Multivariate logistic regression analysis showed four independent risk factors were significantly correlated to the development of DVT, including increased age (OR = 1.17, p = 0.003), diabetes (OR = 1.99, p = 0.009), serum hydroxybutyrate dehydrogenase > 182 U/L (OR = 1.83, p = 0.008), and delay to DUS (in each day) (OR = 1.13, p < 0.001).

Conclusion: In the present cohort study, the incidence of DVT was 12.1% in patients with isolated tibial shaft fracture. We suggest individualized risk stratification and early anticoagulation for patients with high risk factors including pre-existing diabetes, HBDH > 182 U/L, delay to DUS and older age.

Level of evidence: Level III, a prospective cohort study.

Keywords: Deep venous thrombosis; Risk factors; Thromboprophylaxis; Tibial shaft fractures.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Zee AA, van Lieshout K, van der Heide M, Janssen L, Janzing HM (2017) Low molecular weight heparin for prevention of venous thromboembolism in patients with lower-limb immobilization. Cochrane Database Syst Rev 8(8):Cd006681. https://doi.org/10.1002/14651858.CD006681.pub4 - DOI - PubMed
    1. Chen W, Lv H, Liu S, Liu B, Zhu Y, Chen X, Yang G, Liu L, Zhang T, Wang H, Yin B, Guo J, Zhang X, Li Y, Smith D, Hu P, Sun J, Zhang Y (2017) National incidence of traumatic fractures in China: a retrospective survey of 512 187 individuals. Lancet Glob Health 5(8):e807–e817. https://doi.org/10.1016/s2214-109x(17)30222-x - DOI - PubMed
    1. Wennergren D, Bergdahl C, Ekelund J, Juto H, Sundfeldt M, Möller M (2018) Epidemiology and incidence of tibia fractures in the Swedish Fracture Register. Injury 49(11):2068–2074. https://doi.org/10.1016/j.injury.2018.09.008 - DOI - PubMed
    1. Larsen P, Eriksen CB, Stokholm R, Elsoe R (2020) Results following prolonged recovery show satisfactory functional and patient-reported outcome after intramedullary nailing of a tibial shaft fracture: a prospective 5-year follow-up cohort study. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-020-03608-y - DOI - PubMed
    1. Eickhoff AM, Cintean R, Fiedler C, Gebhard F, Schütze K, Richter PH (2020) Analysis of partial weight bearing after surgical treatment in patients with injuries of the lower extremity. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-020-03588-z - DOI - PubMed - PMC

LinkOut - more resources