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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 7, 965-968.
doi: 10.1302/0301-620X.87B7.15989  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Deep-vein thrombosis in high-energy skeletal trauma despite thromboprophylaxis

J. P. Stannard, MD, Orthopaedic Surgeon, Associate Professor of Surgery1; A. K. Singhania, MS, FRCS, Consultant Orthopaedic Surgeon2; R. R. Lopez-Ben, MD, Associate Professor3; E. R. Anderson, MD, Orthopaedic Resident1; R. C. Farris, MD, Orthopaedic Resident1; D. A. Volgas, MD, Orthopaedic Surgeon, Associate Professor of Surgery1; G. R. McGwin, Jr, MS, PhD, Associate Professor of Public Health, Epidemiology1; and J. E. Alonso, MD, Orthopaedic Surgeon, Professor of Surgery1

1 University of Alabama at Birmingham Hospitals, 510 S 20th St., FOT 960 Birmingham, Alabama 35294-3409, USA.
2 Diana Princess of Wales Hospital, Unsthorpe, Grimsby, South Humberside DN33 1NW, UK.
3 Department of Radiology

Correspondence should be sent to Dr J. P. Stannard; e-mail: James.Stannard{at}ortho.uab.edu

We report the incidence and location of deep-vein thrombosis in 312 patients who had sustained high-energy, skeletal trauma. They were investigated using magnetic resonance venography and Duplex ultrasound.

Despite thromboprophylaxis, 36 (11.5%) developed venous thromboembolic disease with an incidence of 10% in those with non-pelvic trauma and 12.2% in the group with pelvic trauma. Of patients who developed deep-vein thrombosis, 13 of 27 in the pelvic group (48%) and only one of nine in the non-pelvic group (11%) had a definite pelvic deep-vein thrombosis. When compared with magnetic resonance venography, ultrasound had a false-negative rate of 77% in diagnosing pelvic deep-vein thrombosis. Its value in the pelvis was limited, although it was more accurate than magnetic resonance venography in diagnosing clots in the lower limbs. Additional screening may be needed to detect pelvic deep-vein thrombosis in patients with pelvic or acetabular fractures.




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Letter from Mr Cooper
Julian P Cooper
J Bone Joint Surg Br Online, 6 Sep 2005 [Full text]
Response to Mr Cooper from the authors
James P Stannard
J Bone Joint Surg Br Online, 14 Oct 2005 [Full text]

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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General