Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.197
Peer-review started: May 27, 2020
First decision: November 25, 2020
Revised: November 25, 2020
Accepted: December 6, 2020
Article in press: December 6, 2020
Published online: January 6, 2021
Processing time: 218 Days and 14.8 Hours
Pulmonary thromboembolism (PTE) is a serious postoperative complication that can occur after a fracture. Generally, PTE is caused by the falling off of lower extremity deep vein thrombosis (LEDVT) after lower limb fracture surgery. LEDVT and PTE after upper extremity fracture surgery are very rare. PTE is one of the most common clinical causes of sudden death. Venous thromboembolism includes PTE and DVT. We experienced one case of LEDVT and PTE after distal ulna and radius fracture surgery. The purpose of our report is to raise awareness for orthopedic surgeons that PTE can occur after distal ulna and radius fracture surgery, and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.
We report a 51-year-old Chinese male who had severe fractures of the left distal ulna, radius and little finger after a motorcycle accident. The patient underwent external fixation, open reduction and internal fixation. On the third post-operative day, computed tomographic pulmonary angiography showed PTE. Doppler ultrasonography showed thrombus formation in the bilateral posterior tibial veins. After a period of anticoagulation therapy, on the 25th d after the PTE, computed tomographic pulmonary angiography showed that thrombus in both sides of the pulmonary artery disappeared. Furthermore, about 4 mo after the PTE, thrombosis in the deep veins of the lower limbs disappeared. About 1 year after the surgery, X-rays showed good fracture healing, and the function of the wrist joint recovered well.
Though rare, PTE can occur after distal ulna and radius fracture surgery and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.
Core Tip: We report a 51-year-old Chinese male who had severe fractures in the left distal ulna, radius and little finger after a motorcycle accident. The patient underwent external fixation, open reduction and internal fixation. On the third postoperative day after the second surgery, he was diagnosed with pulmonary thromboembolism and lower extremity deep vein thrombosis. After 25 d of anticoagulation therapy, computed tomographic pulmonary angiography showed that the thrombus in the pulmonary artery disappeared. This case raises awareness for orthopedics that pulmonary thromboembolism can occur after upper extremity surgery, and that patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.