In-hospital detection of deep vein thrombosis after surgical treatment of open patellar fractures

Deep vein thrombosis (DVT) is an important complication after lower-extremity trauma, but evidence in surgically treated open patellar fractures is limited. We retrospectively studied consecutive patients with open patellar fractures who underwent surgery at two level I trauma centers between November 2013 and January 2023. The primary outcome was detected in-hospital DVT within the inpatient ultrasound surveillance pathway. Univariable logistic regression was followed by a prespecified multivariable model including age, multiple fractures, time from injury to surgery, ASA ≥ III, sodium, prognostic nutritional index, and D-dimer. Among 373 patients, 172 had detected in-hospital DVT (46.1%), most of which were distal events. The primary multivariable model included 325 complete cases and 153 DVT events. Older age (OR 1.047, 95% CI 1.028-1.066), multiple fractures (OR 3.557, 95% CI 1.937-6.531), and longer time from injury to surgery (OR 1.089, 95% CI 1.038-1.142) were independently associated with DVT. These findings support early risk awareness during hospitalization and should be interpreted within the context of routine inpatient ultrasound surveillance.