What a good question and an answer I would like to know too. Contradicting reults have been reported in the literature but I do believe it was dependent upon the study design. I am no orthopedics or traumatology and would like to learn from anyone.
I am not sure a good answer exists. I occasionally see patients on Orthopaedic Wards as referrals and in my limited experience it is often a diagnosis of exclusion (in the absence of post-mortem findings). Pulmonary embolism is far commoner. I will ask a colleague.