Thrombelastography and color Doppler flow imaging in the perioperative period after closed lower limb fracture

徐志強(Xu Zhiqiang，Dept Orthop，Foshan Hosp Tradit Chin Med，Guangzhou Univ Chin Med，Foshan，Guangdong 528000)… ∥ Chin J Orthop Trauma.－2011，13(2).－144～147

Thrombelastography and color Doppler flow imaging in the perioperative period after closed lower limb fracture

徐志強(Xu Zhiqiang，Dept Orthop，Foshan Hosp Tradit Chin Med，Guangzhou Univ Chin Med，Foshan，Guangdong 528000)… ∥ Chin J Orthop Trauma.－2011，13(2).－144～147

ObjectiveTo observe the changes of thrombelastography(TEG)and color Doppler flow imaging(CDFI)in the perioperative period after closed lower limb fracture.MethodsFasting venous blood samples in the morning from 11 healthy adults were used as controls(groupⅠ).Sixty patients with closed femoral fracture were enrolled in groupⅡ，and another 60 patients with closed tibial fracture were enrolled in groupⅢ.The patients in both groups underwent open reduction and internal fixation without anti-coagulation treatment.Fasting venous blood sampling was performed in the early morning for all the patients on the 2nd day after fracture(Ⅱ2 d，Ⅲ2 d)，the operative day(Ⅱ6 d，Ⅲ6 d)，the 2nd day after operation(Ⅱ8 d，Ⅲ8 d)，the 7th day after operation(Ⅱ13 d，Ⅲ13 d)and the 10th day after operation(Ⅱ16 d，Ⅲ16 d).The TEG was observed double blindly by specialists for all the blood samples.CDFI was conducted for samples from groupsⅡandⅢon one day before operation and the 7th day after operation.Results

Compared with groupⅠ，the R and K time decreased and the values of α angle，MA，G and CI on Ⅱ2 d，Ⅱ6 d，Ⅱ8 d，Ⅱ13 d and Ⅱ16 d increased with significant differences.The α angle，MA and G increased significantly on Ⅱ6 d，Ⅱ8 d，Ⅱ13 d and Ⅱ16 d compared with Ⅱ2 d.The α angle，MA and G increased significantly onⅡ8 d，Ⅱ13 d andⅡ16 d compared withⅡ6 d.The α angle and MA increased significantly on Ⅱ13 d andⅡ16 d compared with Ⅱ8 d.The MA and G increased significantly on Ⅲ2 d，Ⅲ6 d，Ⅲ8 d，Ⅲ13 d andⅢ16 d compared with groupⅠ.The MA and G increased significantly onⅢ8 d andⅢ13 d compared withⅢ2 d and Ⅲ6 d respectively.The MA and G increased significantly on Ⅲ16 d compared with Ⅲ2 d，Ⅲ6 d，Ⅲ8 d，Ⅲ13 d.Five patients in group Ⅱ(8.3%)developed deep vein thrombosis(DVT)，4 before operation and one after operation.Three patients in group Ⅲ(3.3%)developed DVT before operation but none after operation.ConclusionThe blood hypercoagulable state is increasing for patients following closed fracture of the lower limb，reaching the peak on the 6th day after fracture or the 2nd day after operation.Patients with closed femoral fracture tend to be in a more serious blood hypercoagulable state than those with closed tibial fracture.CDFI is needed in the perioperative period.10 refs，1 tab.

(Authors)