How to surgically treat venous thrombosis

  Deep vein thrombosis is one of the most common complications of traumatic fractures. It can lead to impaired venous return and cause chronic deep venous insufficiency of varying degrees. The main manifestations are swelling, pain and pressure in the affected limb and varicose veins. It has three major high-risk factors of slow blood flow, venous vessel wall damage and blood hypercoagulability. In severe cases, life-threatening pulmonary embolism may occur.  In general, the incidence of thrombosis is higher in men than in women, and the overall incidence is higher than average in patients of advanced age, obese, smokers, lack of refinement, and those with a history of diabetes, hypertensive disease, and coronary heart disease.  In addition, femoral stem fractures are more likely to develop thrombosis than fractures at other sites. Also, the number of fractures, the degree of comminution, and the occurrence of shock after fracture were correlated with thrombosis.  Again, the incidence of thrombosis was significantly higher in patients with surgical duration greater than 2 hours, massive intraoperative blood transfusion, and general anesthesia!  After suspected thrombosis and confirmed by angiography or venous angiography, attention should be paid to keeping the affected limb at rest and braking, and applying low-molecular heparin subcutaneously. After a week, if the coagulation function is not abnormal, you can change to oral medication, such as rivaroxaban or apixaban.  Of course, each patient’s condition is different. Once it occurs, there is no need to be overly alarmed. Consult a professional vascular surgeon to resolve the problem well.