Ältere Patienten mit intertrochantärer Fraktur nach intramedullärer Fixation: Analyse der Risikofaktoren für eine tiefe Beinvenenthrombose in der Wadenmuskulatur

Abstract

Objective: 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. Material and methods: 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. Results: 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. Conclusion: 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.