Department of Orthopedic Trauma, Honghui Hospital, 12480Xi'an Jiaotong University, Xi'an, Shaanxi Province, the People's Republic of China.
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211067258. doi: 10.1177/10760296211067258.
To explore the correlation between the fracture line inferior plane and perioperative deep venous thrombosis (DVT) in patients with tibial fractures.
Data was collected from the medical records of 536 consecutive patients with tibial fractures at Xi'an Honghui Hospital. The patients were divided into distal, shaft, and proximal segment groups according to the fracture line inferior plane on radiographs. Multivariate logistic regression models were used to identify the role of the inferior plane of the fracture line in perioperative DVT.
A total of 431 patients were included in the study and 226 patients had perioperative DVT in the lower extremities, including 11 proximal and 215 distal DVTs. Univariate regression analysis showed a significant correlation between the proximal segment and perioperative DVT; however, no correlation was found in the shaft segment group. Additionally, age, coronary heart disease, associated injuries, and time to operation ≥6 days were risk factors for perioperative DVT. However, fixation with intramedullary nails may be a protective factor for perioperative DVT compared with plates. After adjusting for potential confounding factors, the proximal segment group had an increased incidence of perioperative DVT compared to the distal segment group.
The proximal segment may be correlated with an increased incidence of perioperative DVT by 7.30-fold in patients with tibial fractures compared to that in the distal segment. In clinical practice, surgeons should be vigilant for DVT formation in these patients.
探讨胫骨骨折患者骨折线下平面与围手术期深静脉血栓形成（DVT）的相关性。
收集西安红会医院 536 例连续胫骨骨折患者的病历资料。根据 X 线片上骨折线下平面将患者分为远段、中段和近段组。采用多变量逻辑回归模型确定骨折线下平面在围手术期 DVT 中的作用。
共纳入 431 例患者，226 例下肢围手术期发生 DVT，其中近端 11 例，远端 215 例。单因素回归分析显示近端段与围手术期 DVT 有显著相关性；而在骨干段组则无相关性。此外，年龄、冠心病、合并伤和手术时间≥6 天是围手术期 DVT 的危险因素。但与钢板相比，髓内钉固定可能是围手术期 DVT 的保护因素。在调整了潜在混杂因素后，与远段相比，近端段患者围手术期 DVT 的发生率增加了 7.30 倍。
与胫骨骨折的远段相比，近端段患者围手术期 DVT 的发生率可能增加 7.30 倍。在临床实践中，外科医生应对这些患者的 DVT 形成保持警惕。
