A 59 years old female pt with a Hx of DVT before 2 years and osteoprosis,not known to have other medical illness ,she falled down off stairs and her leg broken,in hospital x rays done confirmed that she had a displaced tibia and fibula fractures,descision made by orthopedic team to do ORIF , PT and PTT in normal range before operation
Under spinal anesthesia ORIF done successfully without complication, she received klexane after operation and one day post op medical consultation ordered to discuss the previous Hx of DVT, Doppler done was normal ,after that they ordered d dimer which was (4.2) this result was on fourth day again Doppler done and was negative,they ordered PT,PTT,and INR again today waiting for result,my question is is leg swelling normal after ORIF now day 4 and still swelled?? D dimer is it normal after operation if it was high or indicates something?? What is the risk for this pt if there was a DVT to have complications? And there is a DVT what the best mangement?
Yes, leg swelling is common after an ORIF or any injury/ surgery. This occurs due to inflammation and is likely to subside in a few days/ weeks as it heals. However with her history of a previous DVT, the doctors are probably being extra careful to avoid it this time. There are a number of conditions including recent surgery when the D-dimer level can be falsely elevated; however, with a negative Doppler, a DVT is unlikely. The risk of complications with DVT would depend on a number of factors such as size, location etc. Also the management would depend on similar factors and the risk of complications. It would be best to discuss this with your treating doctor.
Hope this is helpful.
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