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Journal of Trauma and Injury 2013;26(3):74-80.
Incidence of Venous Thromboembolism in Pelvic and Acetabular Fractures in the Korean Population
Sang Ki Lee, Jae Won Lee, Jung Joo Hwang
1Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea. sklee@eulji.ac.kr
2Department of Thoracic Surgery, Eulji University College of Medicine, Daejeon, Korea.
한국인의 골반과 비구 골절에서 정맥 혈전색전증의 발병률
이상기, 이재원, 황정주1
을지대학교 의과대학 정형외과학교실, 1흉부외과학교실
Received: 11 March 2013   • Revised: 4 May 2013   • Accepted: 22 August 2013
Abstract
PURPOSE
There are no detailed reports on the incidence of venous thromboembolism (VTE) in pelvic and acetabular fractures in the Asian population. The purpose of this study was to investigate the incidence of VTE in pelvic and acetabular fractures in the Korean population.
METHODS
The cases of 67 Korean patients with pelvic and acetabular fractures treated at our hospital from January 2009 to February 2012 were analyzed retrospectively. Until May 2010, VTE screening was performed by contrast-enhanced computed tomography (CT) or ultrasonography (US) when the D-dimer value did not decline predictably, still exceeded 20 microg/ml at 5 days after trauma and surgery, or increased to greater than 20 microg/ml after a period of decline. After May 2010, contrast-enhanced CT and US were performed routinely irrespective of the D-dimer value. Physical prophylaxis was performed on all patients. The effects of the presence of a pelvic and/or acetabular fracture, and the effects of fracture type, accompanying injuries, and screening strategies on the incidences of VTE were investigated.
RESULTS
Overall, 26 patients(38.8%) were diagnosed with VTE and PTE in 14(20.9%). All were asymptomatic. Significantly higher incidences of VTE and PTE were observed in trauma patients with pelvic and acetabular fractures than in trauma patients without pelvic and acetabula fractures treated during the same period. No significant differences were observed in the incidences of VTE and PTE between patients with pelvic fractures, and patients with acetabular fractures or between patients with and without accompanying injuries. Compared with the previous screening strategy, the detection rates for VTE and PTE were higher for the newer screening strategy; however, the difference did not reach statistical significance.
CONCLUSION
In the Korean population, we should be vigilant for a high incidence of VTE, especially PTE, in patients with pelvic and acetabular fractures.
Key Words: Venous thromboembolism; Pelvis; Acetabulum; Fracture


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