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Master Thesis

Intérêt du diagnostic préopératoire d'une thrombose veineuse profonde avant chirurgie en urgence d'une fracture du plateau tibial

Abstract : Background : The perioperative period in trauma surgery is a well-known risk factor for venous thromboembolic disease, associated with significant mortality and morbidity. The study’s main objective was to evaluate the value of the preoperative diagnosis of deep vein thrombosis (DVT) before emergency surgery of the tibial plateau fracture. Patients and Method : A retrospective study of patients who underwent surgery for a tibial plateau fracture, in the Emergency Department of Lille Hospital and University Centre, between January 2008 and December 2018. Venous doppler ultrasound of the lower limbs was often used to diagnose DVT. Patients were divided into two groups according to whether or not they had a pre-operative doppler ultrasound. Our hypothesis was a decrease in per and post-operative complications in patients with preoperative doppler ultrasound. Results : Two hundred and eighty-five patients were analysed. The incidence of preoperative DVT was 12.2%, with an incidence of proximal DVT of 1.1% and distal DVT of 11.1%. The analysis of both groups revealed only an over-diagnosis of DVT in preoperative doppler ultrasound group (p=0.03). Preoperative doppler ultrasound delayed the operation by one day (p<0.001), without increasing the length of stay. Patients with DVT had a preoperative doppler ultrasound later (p=0.024). Conclusion : Our study did not reveal any significant difference in the number of per- and post-operative complications. Immediate care in the operating room must be recommended to reduce the risk of veinous thromboembolic event. In order to limit the patient’s thrombotic and functional risk, a local management protocol needs to be approved to optimize the care system. An additional prospective and multicenter study is necessary in order to evaluate its relevance.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03435574
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Submitted on : Thursday, November 18, 2021 - 5:55:11 PM
Last modification on : Friday, November 26, 2021 - 12:45:44 AM

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Emmanuelle Gaydier. Intérêt du diagnostic préopératoire d'une thrombose veineuse profonde avant chirurgie en urgence d'une fracture du plateau tibial. Chirurgie. 2020. ⟨dumas-03435574⟩

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