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Updated: Sep 9, 2025
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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
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Rapid-Onset Venous Thrombosis After Tibia Fracture: A Case Report
Caiquan Long1, Zizhen Xie2, Weili Luo3
1Department of Ultrasound, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
The American Journal of Case Reports
|August 31, 2025
Summary
Acute thrombosis can occur within 7.5 hours after knee trauma, challenging traditional views. Early vascular monitoring is crucial for high-risk orthopedic trauma patients to detect hyperacute thrombus formation.
Area of Science:
- Orthopedic Trauma
- Vascular Surgery
- Emergency Medicine
Background:
- Conventional understanding suggests venous thrombosis occurs days after trauma.
- This case challenges this paradigm by demonstrating rapid thrombus formation post-fracture.
Purpose of the Study:
- To report a case of exceptionally rapid venous thrombosis after orthopedic trauma.
- To highlight the need for reassessing current thromboprophylaxis protocols in high-risk patients.
Main Methods:
- Case report of a 43-year-old male with proximal tibia fracture.
- Utilized compression ultrasonography and serial Doppler ultrasound surveillance.
- Monitored D-dimer levels for suspected venous thromboembolism.
Main Results:
- A free-floating thrombus developed in the soleal vein within 7.5 hours post-fracture.
- Elevated D-dimer levels (9.39 mg/L) indicated occult venous thromboembolism.
- No initial deep venous thrombosis detected via compression ultrasonography.
Conclusions:
- Venous thrombosis can develop hyperacutely (within 7.5 hours) after proximal tibia fracture.
- Early and frequent vascular monitoring is critical for high-risk trauma patients.
- Traditional 24-hour thromboprophylaxis may be insufficient for certain high-risk populations.
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