Delayed surgery can increase the preoperative DVT risk in patients with tibial plateau fractures: a retrospective association analysis.

objectiveDeep vein thrombosis (DVT) is a serious complication in patients with tibial plateau fractures, yet the association between surgical delay and preoperative DVT risk remains insufficiently explored. This study aimed to investigate the impact of fracture-to-operation time on preoperative DVT risk in this patient population.

methodsA retrospective association analysis was conducted on 267 patients with tibial plateau fractures treated at Quanzhou Orthopedic Hospital between January 2020 and January 2022. The primary exposure was fracture-to-operation time, and the outcome was preoperative DVT confirmed by ultrasound. Multiple regression analyses and generalized additive models were employed, adjusting for demographic, clinical, and coagulation parameters.

resultsThe incidence of thrombosis before the operation for tibial plateau fractures is as high as 27.34%. Each day of surgical delay was associated with a 48% increased risk of DVT (adjusted OR = 1.48, 95% CI: 1.32-1.67). A non-linear trend was observed, with risk increasing more rapidly within the first 14 days post-fracture. Patients in the highest tertile of surgical delay had a significantly elevated DVT risk compared to the lowest tertile (adjusted OR = 35.27, 95% CI: 9.53-130.56). Subgroup analyses confirmed the robustness of this association across age groups, calcaneus traction status, and D-dimer levels.

conclusionDelayed surgery is associated with increased preoperative DVT risk in tibial plateau fracture patients, and this association appears stronger within the first 14 days post-injury. Early surgical intervention may mitigate this risk, supporting the need for timely management in clinical practice. However, these findings require validation in prospective studies.