Postoperative deep vein thrombosis in patients after selective ankle or mid-hindfoot surgery / 中华创伤骨科杂志

ABSTRACT

Objective:To investigate the prevalence of deep vein thrombosis (DVT) in patients after selective ankle or mid-hindfoot surgery.Methods:A retrospective analysis was conducted of the 109 patients with ankle or mid-hindfoot disease who had been treated from January 2018 to December 2019 at Department of Orthopaedics, Wuhan Fourth Hospital. They were 65 males and 44 females, aged from 32 to 74 years (average, 49.0 years). Ultrasonography was performed at preoperative 1 day, postoperative 2 and 6 weeks to determine the occurrence, location and clinical symptoms of DVT. The patients were divided into an early DVT group, a late DVT group and a DVT-free group according to the occurrence and onset time of DVT. The 3 groups were compared in terms of gender, age, body mass index and tourniquet duration.Results:The incidence of postoperative lower limb DVT was 22.9% (25/109). All the thromboses were observed beyond the distal plane of the popliteal vein. 72.0% of the DVT patients were clinically asymptomatic. There was no significant difference in gender, age or body mass index between early DVT group ( n=17), late DVT group ( n=8) and DVT-free group ( n=84) ( P>0.05). The incidence was 68.0% (17/25) for early DVT and 32.0% (8/25) for late DVT. The intraoperative tourniquet duration for the early DVT group [(77.7±12.3) min] was significantly longer than that for the late DVT group [(66.8±11.2) min] and for the DVT-free group [(65.9±10.5) min] ( P<0.05). Conclusions:The majority of postoperative DVTs may be clinically asymptomatic in patients after selective ankle or mid-hindfoot surgery. Although DVT tends to occur within postoperative 2 weeks, its risk may continue after 2 weeks. Increased tourniquet duration may be associated with incidence of early DVT.