Makhdom Asim M, Garceau Simon, Dimentberg Ronald
Division of Orthopaedic Surgery, McGill University, 1529 Cedar Avenue, Montreal, QC, Canada H3G 1A6 ; Department of Orthopaedic Surgery, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
Case Rep Orthop. 2013;2013:401968. doi: 10.1155/2013/401968. Epub 2013 May 30.
Deep venous thrombosis (DVT) is a significant source of morbidity in orthopaedic surgery. It can progress to a pulmonary embolism, a significant source of mortality. Up to date, patients with Achilles tendon rupture routinely do not receive DVT chemical prophylaxis. We are presenting a case of fatal pulmonary embolism after a surgically treated Achilles tendon rupture in a forty-two-year-old male healthy patient. In the current body of the literature, the reported incidence of DVT after Achilles tendon rupture is highly variable ranging from less than 1% to 34%, and there is a disagreement in the international guidelines regarding the need of chemical DVT prophylaxis with this type of injury. Further research needs to be conducted to investigate the risks and benefits of chemical DVT prophylaxis following Achilles tendon rupture. For low-risk patients, the use of milder forms of prophylaxis such as aspirin should also be explored.
深静脉血栓形成(DVT)是骨科手术中发病的一个重要原因。它可能进展为肺栓塞,而肺栓塞是导致死亡的一个重要原因。到目前为止,跟腱断裂患者通常不接受DVT化学预防。我们报告了一例42岁健康男性患者在接受手术治疗跟腱断裂后发生致命性肺栓塞的病例。在当前的文献中,跟腱断裂后DVT的报告发病率差异很大,从不到1%到34%不等,并且国际指南对于此类损伤是否需要进行DVT化学预防存在分歧。需要进一步开展研究,以调查跟腱断裂后进行DVT化学预防的风险和益处。对于低风险患者,也应探索使用阿司匹林等较温和的预防形式。