Patients with tibial plateau fractures show higher VTE rates than other trauma patients
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The 4% venous thromboembolism or VTE rate researchers found for 571 patients with tibial plateau fractures supports their theory that the non-weight-bearing sometimes needed after fracture treatment may predispose patients to develop a VTE.
At the Virtual EFORT Congress, Erlend Oag presented results of the retrospective study he and his colleagues at the Royal Infirmary of Edinburgh in Scotland conducted, which included 246 patients treated nonoperatively and 325 patients treated with internal fixation for tibial plateau fractures.
All patients were included in a prospective trauma database and treated at Oag’s unit from January 2013 to January 2016. Researchers reviewed electronic notes for the patients regarding VTE incidence, chemoprophylaxis use, medical history and other data, as well as any radiographic evidence of the patients having a VTE after fracture treatment.
In all, researchers found 10 deep venous thromboembolisms (DVTs) and 12 pulmonary embolisms (PEs) for a 2% VTE rate in patients treated nonoperatively.
“Looking solely at the operatively managed patients, the incidence is around 5%. No fatal events were identified and significant risk factors established were being male and non-weight-bearing,” Oag said.
According to the abstract, none of the patients presented with both a DVT and PE.
In other findings of the research, 23 patients were taking some anticoagulation medication for a medical condition at the time of presentation, including apixaban and clopidogrel. In addition, after their tibial plateau injuries, seven patients who had risk factors for VTE that were identified at presentation were prescribed prolonged VTE chemoprophylaxis.
“This study found the rate of VTE after tibial plateau fracture to be higher than that of the general trauma population and higher than that seen in any other lower limb fractures, including ankle fractures. Male sex and non-weight-bearing were both identified as risk factors for developing VTE following tibial plateau fracture in both nonoperatively and operatively managed patients,” Oag said.
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Oag E, et al. Paper 2117. Presented at: Virtual EFORT Congress; Oct. 28-30, 2020.
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