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Updated: Jun 6, 2026
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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Venous thromboembolic prophylaxis for hip fractures
D Marsland1, S C Mears, S L Kates
1Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD 21224-278, USA.
Summary
Hip fracture patients need VTE prophylaxis. Chemical agents like fondaparinux offer better protection than aspirin or mechanical devices, but more research is needed for optimal outcomes.
Area of Science:
- Orthopedic Surgery
- Vascular Medicine
- Pharmacology
Background:
- Patients with hip fractures face a high risk of venous thromboembolism (VTE).
- Effective VTE prophylaxis is crucial for this patient population.
- Current evidence and guidelines require comprehensive review.
Purpose of the Study:
- To review the current evidence on VTE prophylaxis in hip fracture patients.
- To assess the efficacy and limitations of various prophylaxis strategies.
- To identify gaps in knowledge regarding fatal outcomes and mortality.
Main Methods:
- Comprehensive literature review of VTE prophylaxis for hip fracture patients.
- Inclusion of recent guidelines from UK, USA, and Canadian health organizations.
- Assessment of evidence on mechanical devices, aspirin, and various chemical agents.
Main Results:
- Mechanical devices and aspirin are not recommended as sole VTE prophylaxis due to compliance issues and suboptimal efficacy.
- Chemical agents (fondaparinux, warfarin, LMWH, UFH) reduce deep vein thrombosis but lack evidence for reducing fatal PE or mortality.
- Fondaparinux is cost-effective and more efficacious than low-molecular-weight heparin.
Conclusions:
- All hip fracture patients should receive chemical VTE prophylaxis unless contraindicated, typically for at least 28 days.
- Further research is needed to identify agents that reduce fatal pulmonary embolism and all-cause mortality without increasing bleeding risk.
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