1.Study of Deep Vein Thrombosis Screening by using Ultrasound Doppler in Patients with Pelvic and Acetabulum Fractures Requiring Operative Intervention
Hadizie D ; Deyoi YB ; Faisham WI ; Yahaya S ; Ghani SA ; Ahmad-Mohd-Zain MR
Malaysian Orthopaedic Journal 2022;16(No.1):51-57
Introduction: Pelvic and acetabulum fractures are
commonly caused by high impact injuries, increasing the
risk of patients developing thromboembolic diseases such as
deep vein thrombosis (DVT) and pulmonary embolism (PE).
Therefore, this study was performed to determine the
incidence of lower extremity DVT in patients with pelvic
and acetabulum fractures and the importance of preoperative screening with Doppler ultrasound prior to surgical
intervention.
Materials and methods: This retrospective study involved
78 patients with pelvic and acetabulum fractures requiring
surgical intervention from January 2015 until December
2019. Patients who underwent surgical interventions were
screened pre-operatively with Doppler ultrasound to detect
lower limb DVT and later compared with the incidence of
lower limb DVT post-operatively. Descriptive statistical
analysis was performed using IBM SPSS Statistics Version
24.
Results: The participants of this study consisted of 30.8%
females and 69.2% males. Pre-operative screening with
Doppler ultrasound showed that three patients (3.8%) were
diagnosed with lower limb DVT, whereas one of them
(1.3%) was symptomatic and diagnosed with PE. Postoperatively, one patient developed DVT, and one patient
developed PE. Both patients were negative for DVT preoperatively.
Conclusion: The incidence of DVT in patients with pelvic
and acetabulum fractures requiring operative intervention
was significant despite the initiation of mechanical and
pharmacological thromboprophylaxis upon admission.
Despite the low incidence of DVT in our study, it has a high
impact on patients’ morbidity and mortality; thus, preoperative screening is important for early detection and the
subsequent reduction of the risk of developing PE. The
compulsory use of Doppler ultrasound of bilateral lower
limbs as a part of pre-operative screening is highly
recommended because it is cost-effective, efficient and
readily available in most tertiary hospitals nationwide.