Venous Thrombosis in Traumatology and Orthopedics: Diagnostic Difficulties
Abstract
The review provides information about the relevance of the problem of impaired hemostasis after surgery for fractures of long bones and major orthopedic surgical interventions related to operations with a high risk of developing thromboembolic complications, as well as timely and complete diagnosis of these terrible complications. The value of clinical examination data in these patients is low. Instrumental methods allow diagnosing already formed thrombotic masses. This is not enough to carry out appropriate preventive and therapeutic measures. The pre-thrombotic state can be detected through the use of laboratory methods. Of the laboratory tests currently available, only D-dimer levels can help to objectify a patient's thrombotic risk. However, this test has a high diagnostic sensitivity only in the late post-traumatic phase and, at the same time, has a low specificity, especially in patients with trauma and orthopedic profile. Therefore, the determination of D-dimers may not be sufficient to exclude the diagnosis of venous thrombosis in this group of patients.
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