DEEP VEIN THROMBOSIS THAT DEVELOPED PRIOR TO DEFINITIVE TREATMENT IN PATIENTS WITH PELVIC RING OR LOWER-EXTREMITY FRACTURES FOR WHICH EXTERNAL FIXATION WAS PERFORMED AS TEMPORARY TREATMENT

Abstract

　　Lower-extremity fractures (open fractures) with polytrauma and unstable pelvic ring fractures often require external fixation as temporary treatment. However, the prevention of deep vein thrombosis (DVT) is difficult because of the unstable clinical condition and the external fixation. We examined DVT that developed prior to starting definitive treatment in the case of pelvic ring or lower-extremity fractures for which external fixation were performed. In 44 subjects (31 men and 13 women ; average age, 52.0±17.8 years ; average injury severity score (ISS), 24.2±16.5), we evaluated DVT that developed prior to starting definitive treatment during the 3 years from January 2009. DVT occurred in 5 patients (11.4%). There were 3 pelvic ring fractures, 1 open tibia fracture and 1 multiple lower-extremity fracture. One case of pulmonary embolism occurred after definitive treatment. These patients were older and their trauma severity tended to be higher. We conclude that DVT diagnosis prior to starting definitive treatment and prevention of pulmonary embolism is important because prevention of DVT is difficult when the trauma severity is high.