부산대학교 도서관

Patients with pelvic and acetabular fractures are known to be at increased risk for the development of a deep vein thrombosis with thromboembolic complications. The incidence of deep vein thrombosis is between 10% and 60%. Proximal deep vein thrombosis, which is most likely to result in pulmonary embolism, occurs in 25% to 35%. Almost half of all proximal thrombi will be in the pelvic veins. Symptomatic pulmonary embolism has an incidence of 2% to 10%, a greater proportion of patients will have clinically silent embolism. Color flow duplex Doppler ultrasonography is the method of choice in the detection of proximal deep vein thrombosis of the thigh, for the pelvic veins MRI may develop as the new gold standard. Prophylaxis should include low molecular weight heparin, adapted to body weight and mechanical devices such as compression stockings or foot pumps. So far, there are no hard data about controll groups and risk factors, which lead to the insertion of a vena caval filter, although there are promising results about their efficacy. Routinely screening should be performed with duplex Doppler ultrasound, in case of uncertainty venography or MRI must be admitted. In most cases intravenous application of unfractionated heparin or subcutaneous application of low molecular weight heparin is sufficient.