Zhongguo gu shang = China journal of orthopaedics and traumatology · 2026
[Distribution and clinical characteristics of isolated distal deep vein thrombosis after surgery for traumatic thoracolumbar fractures].
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Wang Haiying, Lyu Bing, Li Wei, Xu Jingjing, Ma Ce
Аннотация
OBJECTIVE: To analyze the postoperative thrombus distribution and clinical characteristics of isolated distal thrombosis in patients with traumatic thoracolumbar fractures.
METHODS: A retrospective analysis was conducted on 719 patients with thoracolumbar fractures caused by high-energy injuries who underwent surgical treatment from October 2018 to October 2024. The cohort included 506 males and 213 females,aged from 19 to 69 years with a mean age of (44.82±11.61) years. Postoperative deep venous color Doppler ultrasound of both lower limbs was performed,revealing thrombosis in 149 patients. Based on postoperative thrombus distribution,patients were divided into an isolated distal thrombosis group and a proximal thrombosis group. Clinical data,laboratory indicators,and ultrasound parameters were compared between the two groups. Univariate factors with P<0.05 were further analyzed using binary Logistic regression for multivariate analysis.
RESULTS: Isolated distal deep vein thrombosis(DVT) occurred in 12.4%(89/719) of patients,accounting for 59.7% (89/149) of all DVT cases. Thromboses were located in the posterior tibial vein in 17 cases(19%),peroneal vein in 13 cases(15%),and intermuscular veins in 59 cases (66%). Univariate analysis showed statistically significant differences between the isolated distal thrombosis group and the proximal thrombosis group in leg pain (P=0.016),leg swelling (P=0.013),affected limb circumference difference (P<0.001),D-dimer (P<0.001),blood flow velocity (P<0.001),and peak flow velocity (P<0.001). Logistic regression analysis indicated that,compared with the proximal thrombosis group,the isolated distal thrombosis group had a smaller affected limb circumference difference[OR=0.151,95%CI(0.066,0.347),P<0.001] and lower D-dimer levels [OR=0.734,95%CI(0.580,0.930),P=0.010],while mean blood flow velocity[OR=1.144,95%CI(1.047,1.249),P=0.003] and peak flow velocity[OR=1.379,95%CI(1.169,1.626),P<0.001] were higher.
CONCLUSION: Isolated distal DVT accounts for a relatively high proportion of cases in patients with traumatic thoracolumbar fractures,with intermuscular veins being the most commonly involved. Compared with proximal thrombosis, isolated distal thrombosis is associated with a smaller affected limb circumference difference,lower D dimer levels,and relatively faster blood flow velocity.
METHODS: A retrospective analysis was conducted on 719 patients with thoracolumbar fractures caused by high-energy injuries who underwent surgical treatment from October 2018 to October 2024. The cohort included 506 males and 213 females,aged from 19 to 69 years with a mean age of (44.82±11.61) years. Postoperative deep venous color Doppler ultrasound of both lower limbs was performed,revealing thrombosis in 149 patients. Based on postoperative thrombus distribution,patients were divided into an isolated distal thrombosis group and a proximal thrombosis group. Clinical data,laboratory indicators,and ultrasound parameters were compared between the two groups. Univariate factors with P<0.05 were further analyzed using binary Logistic regression for multivariate analysis.
RESULTS: Isolated distal deep vein thrombosis(DVT) occurred in 12.4%(89/719) of patients,accounting for 59.7% (89/149) of all DVT cases. Thromboses were located in the posterior tibial vein in 17 cases(19%),peroneal vein in 13 cases(15%),and intermuscular veins in 59 cases (66%). Univariate analysis showed statistically significant differences between the isolated distal thrombosis group and the proximal thrombosis group in leg pain (P=0.016),leg swelling (P=0.013),affected limb circumference difference (P<0.001),D-dimer (P<0.001),blood flow velocity (P<0.001),and peak flow velocity (P<0.001). Logistic regression analysis indicated that,compared with the proximal thrombosis group,the isolated distal thrombosis group had a smaller affected limb circumference difference[OR=0.151,95%CI(0.066,0.347),P<0.001] and lower D-dimer levels [OR=0.734,95%CI(0.580,0.930),P=0.010],while mean blood flow velocity[OR=1.144,95%CI(1.047,1.249),P=0.003] and peak flow velocity[OR=1.379,95%CI(1.169,1.626),P<0.001] were higher.
CONCLUSION: Isolated distal DVT accounts for a relatively high proportion of cases in patients with traumatic thoracolumbar fractures,with intermuscular veins being the most commonly involved. Compared with proximal thrombosis, isolated distal thrombosis is associated with a smaller affected limb circumference difference,lower D dimer levels,and relatively faster blood flow velocity.