The Correlation between Lower Extremity Fracture and Subsequent Arterial Embolism and Thrombosis—A National Population Cohort Study

The hazard of subsequent arterial embolism and thrombosis (SAET) in patients with lower leg fractures is not yet well demonstrated. The purpose of this study is to determine the correlation between lower leg fracture and SAET in Taiwan. A total of 134,844 patients with lower leg fractures (ICD-9-CM: 823) and chronological diagnosis as SAET (ICD-9-CM: 444.22) was matched (1:1) to the non-fracture cohort according to their propensity score (data coming from the National Health Insurance database between January 2000 to December 2012). Patients were matched by age, gender, and comorbidities. The incidence of SAET and correlation between SAET development and lower leg fracture was statistically analyzed, and subgroup analysis categorized by characteristics and comorbidities was conducted as well. The cumulative incidence of SAET was calculated by Kaplan–Meier analysis. Kaplan–Meier analysis plot showed that, by the end of the ten-year follow-up period, the cumulative incidence of SAET was significantly higher for the lower leg fracture cohort than for the non-fracture cohort (log-rank test: p < 0.001). The lower leg fracture, male, elder age (45–64-year-old; ≥65-year-old), hypertension, diabetes mellitus, and gout were significantly associated with lower extremity SAET risk compared with the matched group. There was an inseparable correlation between the lower leg fracture group and the risks of SAET; subgroup analysis by gender (male, female), age (age < 40 years, age 40–64 years, and age > 65 years) and comorbidities (hypertension, diabetes mellitus, and gout) show compatible results as well. Patients with lower leg fracture have a significantly increased risk of SAET since then two years after the fracture. The hazard of SAET was significantly higher in patients with lower leg fracture than in the non-fracture cohort, and the high incidence was found since then two years after fracture. Further studies are warranted.

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Bone remodelling following a lower leg fracture in the 11,000-year-old hunter-gatherer from Vado all' Arancio (Italy)

International Journal of Osteoarchaeology ◽

10.1002/oa.639 ◽

2002 ◽

Vol 12 (6) ◽

pp. 402-406 ◽

Cited By ~ 6

Author(s):

B. M. Holt ◽

G. Fornaciari ◽

V. Formicola

Keyword(s):

Bone Remodelling ◽

Lower Leg ◽

Lower Leg Fracture ◽

Leg Fracture

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Persistence of Opioid Prescribing after a Forearm or Lower Leg Fracture

Journal of General Internal Medicine ◽

10.1007/s11606-017-4214-8 ◽

2017 ◽

Vol 33 (3) ◽

pp. 251-252 ◽

Cited By ~ 1

Author(s):

Ning N. Yu ◽

Chao Zhou ◽

Curtis Florence ◽

Jan L. Losby

Keyword(s):

Lower Leg ◽

Opioid Prescribing ◽

Lower Leg Fracture ◽

Leg Fracture

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Clinical efficacy of AngioJet™ mechanical thrombectomy for the treatment of acute lower extremity arterial embolism and thrombosis

Vascular Investigation and Therapy ◽

10.4103/vit.vit_15_20 ◽

2020 ◽

Vol 3 (3) ◽

pp. 71

Author(s):

Quan Chen ◽

Qibing Niu ◽

Shiqi Wen ◽

Anqiang Li ◽

Fang Dong ◽

...

Keyword(s):

Lower Extremity ◽

Clinical Efficacy ◽

Mechanical Thrombectomy ◽

Arterial Embolism ◽

Embolism And Thrombosis

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Muscle Contraction Protects Against Lower Leg Fracture

Skiing Trauma and Safety: Tenth Volume ◽

10.1520/stp37922s ◽

2009 ◽

pp. 119-119-7

Author(s):

A Ekeland ◽

L Nordsletten

Keyword(s):

Muscle Contraction ◽

Lower Leg ◽

Lower Leg Fracture ◽

Leg Fracture

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Soft-tissue reconstruction in lower-leg fracture-related infections: an orthoplastic outcome and risk factor analysis

Injury ◽

10.1016/j.injury.2021.07.022 ◽

2021 ◽

Author(s):

Seraina L.C. Müller ◽

Mario Morgenstern ◽

Richard Kuehl ◽

Thaddaeus Muri ◽

Daniel F. Kalbermatten ◽

...

Keyword(s):

Factor Analysis ◽

Risk Factor ◽

Soft Tissue ◽

Lower Leg ◽

Risk Factor Analysis ◽

Soft Tissue Reconstruction ◽

Lower Leg Fracture ◽

Tissue Reconstruction ◽

Leg Fracture

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Acute Compartment Syndrome after Lower Leg Fracture

European Journal of Trauma ◽

10.1007/s00068-004-1301-4 ◽

2004 ◽

Vol 30 (2) ◽

pp. 93-97 ◽

Cited By ~ 6

Author(s):

Johan G. H. van den Brand ◽

Nico L. Sosef ◽

Egbert J. M. M. Verleisdonk ◽

Christian van der Werken

Keyword(s):

Compartment Syndrome ◽

Lower Leg ◽

Acute Compartment Syndrome ◽

Lower Leg Fracture ◽

Leg Fracture

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Unilateral spinal anaesthesia in a patient with Osteogenesis Imperfecta with a lower leg fracture: a case report

Injury ◽

10.1016/s0020-1383(13)70198-0 ◽

2013 ◽

Vol 44 ◽

pp. S49-S51 ◽

Cited By ~ 2

Author(s):

Senka Baranovic ◽

Ivan Zvonimir Lubina ◽

Tomislav Vlahovic ◽

Bore Bakota ◽

Branka Maldini

Keyword(s):

Case Report ◽

Osteogenesis Imperfecta ◽

Spinal Anaesthesia ◽

Lower Leg ◽

Lower Leg Fracture ◽

Leg Fracture

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Changing epidemiology of lower extremity fractures in adults over a 15-year period – a National Hospital Discharge Registry study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04291-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Philipp Hemmann ◽

Maximilian Friederich ◽

Daniel Körner ◽

Tim Klopfer ◽

Christian Bahrs

Keyword(s):

Lower Extremity ◽

Hospital Discharge ◽

Age Groups ◽

Lower Leg ◽

Total Count ◽

Ageing Population ◽

National Hospital ◽

Hospital Discharge Registry ◽

Femur Fractures ◽

Lower Leg Fracture

Abstract Background Demographic changes led to an increasingly ageing population in Germany and thus to possible changes in the frequency of fractures. The primary aim of this study was to report changes in fracture rates of the lower extremities in Germany in 2002 compared to 2017 and to evaluate those changes. Methods Inpatient data from the German National Hospital Discharge Registry (ICD10) for 2002 and 2017 were evaluated. Changes in total counts and incidence rates were analysed for fractures in the following locations: femoral neck, pertrochanteric, subtrochanteric, distal femur, femoral shaft, proximal and distal tibia, tibial shaft, medial and lateral malleolus, and other parts of the lower leg (including bi- and trimalleolar fractures), calcaneus, talus, other tarsal bones, metatarsal bones, greater toe, lesser toe, other fractures of foot or unspecific fractures of foot and toe. Patients were classed into age groups by sex: 15–24, 25–34,35–44, 45–54, 55–64, 65–74, 75–84, 85–90 and > 90 years. Results The total count for lower extremity fractures in men and women increased slightly by 4.5% from 305,764 in 2002 to 319,422 in 2017. Hip and femur fractures increased by 23.5% from 150,565 in 2002 to 185,979 in 2017. The number of these fractures among men increased by 46% and among women by 15.3%. The total count of lower leg fractures decreased by 15.4% from 131,162 in 2002 to 110,924 in 2017. Especially, younger age groups showed a decline for all tibial segments and ankle fractures. For both sexes, the number of lower leg fractures in those 75 years or older increased in all lower leg fracture locations. Most femur and lower leg fractures occurred in women. The incidence of fractures rose sharply from 2002 to 2017, especially for older cohorts. Conclusion The total numbers of lower extremity fractures increased slightly in 2017 compared to 2002 – especially hip and femur fractures among men. The incidence of almost all lower extremity fracture types among older people increased during this time. Women were particularly affected. Therefore, focused prevention programmes should be considered including an extended fracture spectrum in the elderly.

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