SIGNIFICANCE OF INCREASED D-DIMER VALUES IN FRESH FRACTURES IN ORTHOPEDICS AND CORRELATIONS WITH THROMBOEMBOLIC COMPLICATIONS

Saša Jovanović; Elek Zlatan; Dušan Petrović; Gojko Igrutinović; Danijela Vićentijević; Aleksandar Božović

doi:10.35120/medisij010217j

Authors

Saša Jovanović CHC KosovskaMitrovica, Department of Orthopedic Surgery and Traumatology, Serbia
Elek Zlatan CHC KosovskaMitrovica, Department of Surgery, Serbia, Faculty of Medicine, University of Priština, Kosovska Mitrovica, Serbia
Dušan Petrović CHC KosovskaMitrovica, Department of Orthopedic Surgery and Traumatology, Serbia, Faculty of Medicine, University of Priština, KosovskaMitrovica, Serbia
Gojko Igrutinović CHC KosovskaMitrovica, Department of Surgery, Serbia, Faculty of Medicine, University of Priština, KosovskaMitrovica, Serbia
Danijela Vićentijević CHC KosovskaMitrovica, Department of Anesthesiology, Serbia
Aleksandar Božović CHC KosovskaMitrovica, Department of Orthopedic Surgery and Traumatology, Serbia, Faculty of Medicine, University of Priština, KosovskaMitrovica, Serbia

DOI:

https://doi.org/10.35120/medisij010217j

Keywords:

D-dimer, thromboembolism, fractures, prediction

Abstract

Background/aim. At the end of the process of separating clots composed of fibrin we have a D-dimer. This process involves thrombin, which is formed during the process where fibrinogen is converted into fibrin, a factor whose role is to bind the basic units of clots and plasmin, the final participant in the breakdown of fibrin. In medicine, we should not use value of D-dimers as the only parameter for thrombosis. The aims of are research is to investigate correlation between clinical signs of venous thrombosis and D-dimer values in fresh bone fractures and demonstrate, that there is momentous correlation between high values of D-dimers and clinical signs of venous thrombosis, which is often a contraindication for surgical treatment of fractures.
Methods: D-dimer levels of 211 patients with fresh bone fractures. They are classified into groups based on D-dimer values as follows: <250 ng/ml, 250–1000 ng/ml, 1000-5000 ng/ml, 5000-10 000ng/ml.
Results: D-dimer values are not statistically significant with clinical symptoms of venous thrombosis in recent fractures in orthopedics.
Discussion: D-dimer is an indicator related to fibrin degradation that has been used in the past as a prevalence in patients with chances of venous thrombosis. In inflammatory processes, we also have increased values of this parameter, which suggests the existence of some inflammatory change in the body or infection. Оur research is among the first to compare D-dimer values in recent fractures in orthopedics and thromboembolic complications. In our research, we showed that there is no significant correlation between elevated D-dimer values in hospitalizations of fresh fractures with clinical signs and a diagnosis of vascular thrombosis. We showed that there is no significant correlation between elevated D-dimer values in hospitalizations of fresh fractures with clinical signs and a diagnosis of vascular thrombosis. With this study, we proved that elevated D dimer is a consequence of trauma and disruption of the continuity and integrity of bone blood vessels, both endosteal and periosteal, which results in thrombosis of small blood vessels.
Conclusions: There is no momentous correlation between elevated D-dimer values in fresh fractures and venous thrombosis. High values of D-dimer are not a contraindication for surgical treatment of fresh fractures.

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