Correlation Study Between The Location Of Lower Limb Fractures And The Occurring Of Lower Extremity Deep Vein Thrombosis

Objective:To study the association of lower limb fractures site with the occurring of lower extremity deep vein thrombosis by analyzing different lower limb fracture patients' level of D-dimer,incidence and site of deep vein thrombosis.Method:The lower limb fracture cases from January 2012 to December 2015 in our department of orthopedic are accepted to the observation samples.The color Doppler ultrasound was performed to check their lower extremity deep veins.The anatomical sites of fracture were subdivided into five segments:foot and ankle fracture,lower leg fracture,knee fracture,femoral shaft fracture,proximal femoral fracture.A retrospective analysis was performed to analyze the correlation between fracture and thrombosis,the level of D-dimer and the incidence of thrombosis.According to the anatomical site and extent,the thrombosis were divided into high risk group and low risk group on the basis of the risk of pulmonary thromboembolism to test if the distribution of high risk and low risk thrombosis differed in every fracture segments.Result:In this study,127 consecutive patients presenting with LEDVT after fracture were available,of whom 73 had fracture isolated to the left lower limb and 54 had fracture isolated to the right lower limb.LEDVT involved one side of the lower limb in 122 patients and two sides in 5 patients.In total,the thrombosis occurs in 132 unilateral lower limb,72 in left lower limb and 60 in right lower limb.There are 119 thrombuses exiting in the same side with fracture,and 13 thrombuses exiting in the oppisite side with fracture.The incidence of thrombosis in the same side of the fracture is higher than that in the oppisite side(P<0.05)There is no statistical difference in the left and right side distribution of the thrombosis and fracture(P>0.05).There is statistical difference in the fracture patients' distribution of the thrombosis and the total LEDVT patients'(P<0.05).The foot and ankle fracture has lower level of D-dimer(1.81 3.20mg/L)and incidence of deep vein thrombosis(0.4%)than other fractures(lower leg fracture:3.70 3.95mg/L?3.4%,knee fracture:4.26 6.18 mg/L?6.6%,femoral shaft fracture:4.49 6.08 mg/L?5.1%,proximal femoral fracture:4.93 5.99 mg/L.5.8%).Statistical significance was accepted.(P<0.05)There is no statistical difference in the level of D-dimer and the incidence of thrombosis in the remaining groups.The incidence of high risk thromboses of knee fracture(66.7%),femoral shat fracture(68.2%)and proximal femoral fracture(61.3%)is higher than lower leg fracture(25.9%)(P<0.05).Statistical significance was not accepted.(P>0.05).Conclusion:The thromboses of the lower extremity fracture patients are inclined to be in the same side of the fractures.The foot and ankle fracture has the lowest level of hypercoagulation and incidence of thrombosis.The risk of the thromboses in knee fracture,femoral shaft fracture or proximal femoral fracture patients is higher than that in patients with lower leg fracture.