title: [Case-control study on ultra-early application with intermittent pneumatic compression to prevent postoperative deep venous thrombosis of intertrochanteric femoral fracture in elderly patients].
abstract: OBJECTIVE
  To evaluate the clinical effects of ultra-early application with intermittent pneumatic compression (IPC) in preventing postoperative lower limbs deep venous thrombosis (DVT) of intertrochanteric fractures in elder patients.
  
  
  METHODS
  From May 2008 to May 2010, 80 patients with intertrochanteric fractures were randomly divided into ultra-early group and postoperative group. In ultra-early group, there were 21 males and 19 females, ranging in age from 67 to 86 years with an average of (76.4 +/- 13.27) years; in postoperative group, there were 26 males and 14 females, ranging in age from 68 to 89 years with an average age (75.8 +/- 12.71) years. IPC was respectively used at the 3rd day before operation (ultra-early group) and postoperative that day (postoperative group). Serum D-dimer of all the patients were measured at the 3rd day before operation and at the 3rd, 7th,14th days after operation. Lower limbs DVT were observed by ultrasound at the 3rd, 14th days postoperatively. Perioperative bleeding volume of patients were compared between two groups.
  
  
  RESULTS
  There was no statistical difference in the serum D-dimer concentration and lower limbs DVT between two groups at the 3rd day before operation (P > 0.05). There was no statistical difference in perioperative bleeding volume between two groups (P > 0.05). In ultra-early group, Serum D-dimer concentration at the 3rd, 7th days after operation was respectively (351.00 +/- 104.34), (412.31 +/- 106.95) microg/ml; and in postoperative group, the item was respective (419.34 +/- 145.38), (509.16 +/- 146.05) microg/ml; serum D-dimer concentration in ultra-early group was lower than postoperative group (P < 0.05). There was no significant differences in serum D-dimer concentration at the 14th day after operation between two groups (P > 0.05). Incidence of DVT in postoperative group was 22.5%, which was higher than that of ultra-early group at the 14th day after operation (P < 0.05). There was no significant differences at the 3rd day after operation between two groups (P > 0.05).
  
  
  CONCLUSIONS
  Compared with postoperative application with IPC, ultra-early application with IPC could reduce the level of serum-dimer and the incidence of DVT without increase perioperative blood of intertrochanteric fracture in elder patients.
authors.affiliation: Department of Orthopaedics, Hospital of TCM of Zhejiang Provice, Hangzhou 310006, Zhejiang, China. dliju@yahoo.cn
authors.forename: Ju
authors.initials: J
authors.lastname: Li
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Ji
authors.forename: Pei-Jian
authors.initials: PJ
authors.lastname: Tong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D013997:Time Factors; D020246:Venous Thrombosis / Q000517:prevention & control*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D