title: Venous thromboembolism in Japanese patients with fractures of the pelvis and/or lower extremities using physical prophylaxis alone.
abstract: OBJECTIVE
  To investigate the rate of venous thromboembolism (VTE) in Japanese patients with fractures of the pelvis and/or lower extremities using physical prophylaxis alone.
  
  
  METHODS
  Records of 66 men and 60 women aged 15 to 95 (mean, 57) years with fractures of the pelvis and/ or lower extremities were retrospectively reviewed. They were screened for VTE based on D-dimer values. Contrast-enhanced computed tomography and/or ultrasonography were performed when the D-dimer value did not decline predictably or exceeded 20 μg/ml even 5 days after injury or surgery. Physical prophylaxis for VTE in terms of graduated compression stockings and intermittent pneumatic compression were applied for all patients.
  
  
  RESULTS
  Of the 126 patients, 24 were detected to have VTE (10 of 29 with multiple fractures and 14 of 97 with single fractures). Six patients were detected to have asymptomatic pulmonary thromboembolism (PTE), whereas 20 patients were detected to have deep vein thrombosis (bilaterally in 7). The rates of VTE were high in patients with multiple fractures (35%), pelvic fractures (18%), and femoral shaft fractures (50%). The rate of PTE was high in patients with pelvic fractures (12%).
  
  
  CONCLUSIONS
  The rate of VTE in the Japanese patients was similar to that in western populations. Our screening method was useful for preventing fatal PTEs. Surgeons should be vigilant for VTE during the first 2 weeks after injury, especially in patients with multiple and pelvic fractures.
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan. tniikura@med.kobe-u.ac.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Niikura
authors.forename: Sang Yang
authors.initials: SY
authors.lastname: Lee
authors.forename: Keisuke
authors.initials: K
authors.lastname: Oe
authors.forename: Akihiro
authors.initials: A
authors.lastname: Koh
authors.forename: Takaaki
authors.initials: T
authors.lastname: Koga
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Dogaki
authors.forename: Etsuko
authors.initials: E
authors.lastname: Okumachi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kurosaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D007867:Leg Bones / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies; D053828:Stockings, Compression; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult