Bosworth骨折是一种少见的踝关节骨折,由踝关节被动旋后、外翻造成,腓骨交锁于胫骨后方,手法不能使腓骨复位,最终采取手术治疗.该型骨折易于误诊,早期行螺旋CT平扫加三维重建可以明确诊断.%Obj ective To explore the indicators of vena cava filters ( VCFs) implementation for treating deep venous thrombosis(DVT) secondary to trauma and how to select among different types of VCFs. Methods A retrospective review was applied on 80 DVT patients secondary to trauma in trauma center, Daping Hospital of Third Military Medical University from Jan. 2009 to Jan. 2012. Results In 80 DVT patients secondary to trauma,79 cases were cured, 1 case died (ISS 29,due to MODS). Totally 35 patients took selective insertion of inferior vena cava filter ( recyclable filter in 11 cases,permanent filter in 24 cases). The indications were: (1) elder; (2) the central type and mixed type DVT patients; (3) a previous history of DVT; (4) anticoagulation contraindications; (5) the ISS > 16; (6) pulmonary embolism in high-risk patients. Conservative treatment was conducted in 45 cases,mainly by hepann or low molecular weight hepann and other anticoagulant therapies, there were 2 cases of pulmonary embolism ( PE) , and permanent filter implantation was taken and cured. Conclusion ISS > 16,prolonged bed rest,history of smoking,diabetes,hypertension,coronary heart disease,bleeding are high risk factors of DVT. In spite of the risk of thromboembolism in trauma patients is transient,temporary VCFs is not the first choice. Early care and. prevention measures are keys to manage DVT. Acute DVT which requires filter implantation should strictly grasp the indications, and try applying the temporary or recyclable filter,which has important significance for prognosis.
展开▼
