State of venous blood flow in the lower extremitiesof patients with fractures of the tibia after plate osteosynthesis
Journal Title: Orthopaedics, Traumatology and Prosthetics - Year 2016, Vol 602, Issue 1
Abstract
Violation of antegrade blood flow, deep vein thrombosis and pulmonary embolism (PE) presents the complex problem in the treatment of trauma patients. The goal: to examine the state of antegrade blood flow in the vessels of lower extremities in patients with fractures of the long bones of lower leg after surgery using on-bone plates. The methods: clinical-laboratory and Doppler study of 56 pa-tients (33 men and 23 women aged from 19 to 62 years) were performed. Fractures in the lower third of the tibia were found in 17 (30.3 %) patients, in the middle third — in 29 (51.7 %), at the top — in 10 (18 %). All patients at different times after injury underwent an open reduction and fixation of bone fragments of leg bones with LCP-plates. The patients, who had such pathology as chronic thrombophlebitis, cardiovascular or cancer diseases, overweight or had a history of episodes of pulmonary embolism (PE) before injuries were not included in the study. Results: it was found that surgical treatment provokes considerable disturbances in the hemostatic system with the development of deep vein thrombosis of the injured limb. After the surgery, a positive test for D-dimer and a significant increase in the level of soluble fibrin-monomer complex was observed in 34 (60.7 %) patients, that was almost twice the number of such cases in preoperative period. Thrombosis of shin venous on the level of surgery with signs of flotation and proximal distribution was revealed on Doppler ultrasound investigation. Conclusions: the patients who have undergone surgery to stabilize bone fragments using LCP-plates, are at risk of pathological thrombus formation in the veins of the operated limb and the need for timely diagnosis and adequate treatment of this disease in order to avoid dangerous complications such as thrombotic disease of the lower extremities and pulmonary embolism (PE).
Authors and Affiliations
Dmitro Babun, Petro Zhuk
Keywords
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- EP ID EP203521
- DOI 10.15674/0030-59872016150-53
- Views 292
- Downloads 0
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