Su Hao, Liu Hongzhi, Liu Juan, Wang Xin
Department of Traumatic Orthopaedics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong Province, China.
Yantai Center for Disease Control and Prevention, Yantai, Shandong Province, China.
Orthopade. 2018 Apr;47(4):341-346. doi: 10.1007/s00132-018-3552-5.
Calf muscular vein thrombosis (CMVT) has been known for approximately 40 years and many research studies for CMVT have been conducted but many opinions about the incidence and risk factors are still controversial. The objective of this retrospective study was to investigate the incidence and analyze the risk factors for CMVT in elderly patients with isolated intertrochanteric fractures that were managed surgically.
The medical documents of patients suffering from intertrochanteric fractures who were treated in the traumatic orthopaedics department of our hospital from January 2009 to August 2017 were reviewed. The patients were allocated to the CMVT group and non-CMVT group basing on color Doppler flow imaging examination, according to the inclusion and exclusion criteria. The clinical data such as age, gender, body mass index (BMI) and the Working Group on Osteosynthesis Questions/American Orthopaedic Trauma Association (AO/OTA) classification of fractures were collected. Logistic regression analysis was used to determine the independent risk factors for CMVT.
In total, 312 patients were included in this study of which 31 patients were diagnosed with CMVT and allocated to the CMVT group and 281 patients were excluded from suffering from CMVT and included in the non-CMVT group. The incidence of CMVT was 9.94% in our study. The multivariate logistic regression showed that a fracture classification of A3, diabetes, time between injury and operation greater than 48 h are independent risk factors for CMVT in elderly patients with intertrochanteric fractures after intramedullary fixation.
Complicated fractures, diabetes and prolonged time from injury to surgery are risk factors for CMVT in elderly patients with intertrochanteric fractures treated with intramedullary fixation.
小腿肌肉静脉血栓形成（CMVT）已被知晓约40年，针对CMVT已开展了许多研究，但关于其发病率和危险因素的诸多观点仍存在争议。这项回顾性研究的目的是调查老年孤立性转子间骨折手术患者中CMVT的发病率，并分析其危险因素。
回顾了2009年1月至2017年8月在我院创伤骨科接受治疗的转子间骨折患者的病历。根据彩色多普勒血流成像检查结果，按照纳入和排除标准将患者分为CMVT组和非CMVT组。收集患者的年龄、性别、体重指数（BMI）以及骨折的骨科学问题工作组/美国矫形创伤协会（AO/OTA）分类等临床资料。采用逻辑回归分析确定CMVT的独立危险因素。
本研究共纳入312例患者，其中31例被诊断为CMVT并分配至CMVT组，281例未患CMVT被纳入非CMVT组。本研究中CMVT的发病率为9.94%。多因素逻辑回归显示，A3型骨折、糖尿病、受伤至手术时间大于48小时是老年转子间骨折髓内固定术后发生CMVT的独立危险因素。
复杂骨折、糖尿病以及受伤至手术时间延长是老年转子间骨折髓内固定治疗患者发生CMVT的危险因素。
