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Trombosis venosa de inicio rápido después de la fractura de la tibia: un informe de caso
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
Resumen
La trombosis aguda puede ocurrir dentro de las 7.5 horas después de un trauma en la rodilla, desafiando los puntos de vista tradicionales. El monitoreo vascular temprano es crucial para los pacientes con trauma ortopédico de alto riesgo para detectar la formación de trombos hiperaguda.
Área de la Ciencia:
- Trauma ortopédico
- Cirugía vascular
- Medicina de emergencia
Sus antecedentes:
- La comprensión convencional sugiere que la trombosis venosa ocurre días después del trauma.
- Este caso desafía este paradigma al demostrar la formación rápida de trombos después de la fractura.
Objetivo del estudio:
- Para reportar un caso de trombosis venosa excepcionalmente rápida después de un trauma ortopédico.
- Para resaltar la necesidad de reevaluar los protocolos actuales de tromboprofilaxis en pacientes de alto riesgo.
Principales métodos:
- Informe de caso de un hombre de 43 años con fractura de tibia proximal.
- Utilizó ultrasonografía de compresión y vigilancia de ultrasonido Doppler en serie.
- Monitoreo de los niveles de D-dimero en caso de sospecha de tromboembolismo venoso.
Principales resultados:
- Un trombo flotante se desarrolló en la vena sola dentro de las 7.5 horas posteriores a la fractura.
- Los niveles elevados de D-dimero (9,39 mg/L) indicaron tromboembolismo venoso oculto.
- No se detectó trombosis venosa profunda inicial mediante ecografía de compresión.
Conclusiones:
- La trombosis venosa puede desarrollarse de forma hiperaguda (dentro de las 7.5 horas) después de la fractura de la tibia proximal.
- El monitoreo vascular temprano y frecuente es crítico para los pacientes con trauma de alto riesgo.
- La tromboprofilaxis tradicional de 24 horas puede ser insuficiente para ciertas poblaciones de alto riesgo.
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