Thromboembolic prophylaxis in hip fracture

Area of Science:

• Orthopedic Surgery
• Vascular Medicine
• Pharmacology

Background:

• Intertrochanteric femur fractures are common, particularly in women.
• Deep-vein thrombosis (DVT) is a significant complication following orthopedic surgery.
• Anticoagulation strategies are crucial for preventing DVT in at-risk patients.

Purpose of the Study:

• To compare the efficacy of heparin-dihydergot versus heparin-acenocoumarin in preventing DVT.
• To evaluate the incidence of DVT in women undergoing Ender nailing for intertrochanteric femur fractures.

Main Methods:

• A study involving 181 women with intertrochanteric femur fractures treated with Ender nailing.
• Patients received either heparin-dihydergot or heparin-acenocoumarin.
• Deep-vein thrombosis screening using the 125-I-fibrinogen uptake test and bilateral ascending venography.

Main Results:

• Deep-vein thrombosis developed in 40% of patients treated with heparin-dihydergot.
• Deep-vein thrombosis developed in 61% of patients treated with heparin-acenocoumarin.
• The difference in DVT incidence between the two groups was statistically significant (p < 0.015).

Conclusions:

• Heparin-dihydergot demonstrated a lower incidence of deep-vein thrombosis compared to heparin-acenocoumarin.
• Heparin-dihydergot may be a more effective prophylactic agent for DVT in this patient population.
• Further research may explore optimal anticoagulation protocols for femur fracture patients.