European journal of trauma and emergency surgery : official publication of the European Trauma Society
Preoperative prevalence and risk factors for thromboembolic events following tibial plateau fractures: a retrospective analysis of an underestimated risk
By Herold J, Lorenz ED, Eymann H and 9 others.
Abstract
Background
Tibial plateau fractures (TPF) are complex intra-articular injuries carrying a high risk of deep vein thrombosis (DVT), muscular vein thrombosis (MVT) and pulmonary embolism (PE). Preoperative thrombosis is frequently clinically silent yet may cause serious complications, whereas its detection delays definitive surgery. This study assessed the prevalence and risk factors of preoperative venous thromboembolic events (VTE) in surgically treated TPF before and after implementation of routine duplex ultrasound screening.
Methods
In this retrospective single-centre study at a level 1 trauma centre, all adult patients surgically treated for traumatic TPF (AO 41B/C) between January 2015 and August 2025 were reviewed (547 patients, 554 fractures). Until August 2020 duplex ultrasound (DUS) was performed only on clinical suspicion; from August 2020 onward routine preoperative DUS was progressively implemented. VTE were confirmed by DUS or CT angiography. Prevalences are reported per fracture and patient characteristics per patient; regression analyses were performed at fracture level, except for the patient-related model.