Study of Deep Vein Thrombosis in Fractured Lower Extremities Using Doppler Ultrasonography

Abstract

Early identification of deep venous thrombosis (DVT) in trauma patients would result in an early initiation of treatment, thereby decreasing the frequency of complications. The aim was to study the deep vein thrombosis in fractured lower extremities using Duplex ultrasonography This prospective study was carried out at Ribat Universal Hospital in Khartoum Sudan from January 2016 and March 2018 included 176 patents(129 males and 47 females; mean age of 51.5±19.5 years) with fractured lower extremities were thoroughly evaluated by Doppler exam with respect to fracture site and pattern, fixation type, associated injuries, time before immobilization, and venous Duplex ultrasound (VDUS) findings. Each affected limb was assessed for the presence of DVT using a Sonoline G 60S ultrasound (US) unit. The analysis was performed with the Statistical Package for the Social Sciences (SPSS) version 22. The incidence of DVT in the current study was (12.5%) the high rates of DVT noted in 10(16.4%) patients with age group (58-77)years old, 10(13.7%)patients with periacetabuler fractures, 5(20.%) patients with femur fractures,3(23.1%) patients with multiple fractures,6(20%) patients with late immobilization more than10hours, 3(42.9%)patient with TBS fixation and 3(23%)patients having multiple fractures. Sensitivity and specificity of the findings of compressibility and respiratory phasicity for DVT detection in patients with fractured lower extremities were 81.25% and 87.50% and 100% and 100% respectively. In addition, the absence of compressibility and phasicity had positive predictive value (PPV) of 100% and 100% and negative predictive value (NPV) of 93.75% and 95.65% respectively. In this study the rate of DVT was high on complex fractures, delayed immobilization and on fractures that immobilized by traditional bone setter (TBS). US exam of DVs in the brightness mode (B-mode) with compression maneuvers should be the first-line imaging modality for suspected DVT in patients with fractured lower extremities.