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General Orthopaedics

INCIDENCE OF THROMBOEMBOLISM IN PATIENTS TREATED WITH RING FIXATORS

British Limb Reconstruction Society (BLRS) AGM & Instructional Course



Abstract

AIM

To study the incidence of thromboembolism among patients treated with ring fixators in lower limb injuries and their risk factor association.

METHODS & MATERIALS

Notes of 180 (130 men & 50 women) patients treated with circular frame were retrospectively studied. Risk factors for thromboembolism as advised by NICE were recorded and scored. The duration of pre-operative limb immobilisation, hospital stay and duration of frame, were also recorded.

RESULTS

Amongst 180 patients, there were 133 closed and 47 open tibial fractures. 4.4% (n=8) of patients suffered thromboembolic (4 DVT, 4 PE) event, which varied from early post op (13 days) period to delayed period (107 days post surgery). None of the patients were on prophylactic anticoagulation when they suffered thromboembolic event. Their average BMI was 31.3 ± 3.8 (S.D) while it was 27.2 ± 4.8 (S.D) for the rest. Other risk factors did not influence thromboembolic events.

Patients affected by thromboembolic complications had the limb immobilised for 6.59 days (0 to 31), spent 20.5 days (7 to 44) in hospital and 29.4 weeks (11 to 54) in frame versus 6.15 days (0 to 35), 14.39 days (3 to 74) and 25.67 weeks (10 to 111) respectively in patients without thromboembolic complications.

CONCLUSION

Small patient pool is the limitation of our study; however, obesity appears to be a risk factor. Incidence of thromboembolic events is significant enough to consider routine prophylaxis, although both prophylaxis and duration is open to debate.