Thromboembolism (Subscribe)  

NEW YORK (Reuters Health) Apr 02 - A review of studies looking at anticoagulant prophylaxis after hip and knee arthroplasty reveals that not only do these agents fail to completely prevent pulmonary embolism (PE), their use may actually increase all-cause mortality. The results, which appear in the March issue of Clinical...

Antithrombotic Therapy. SIGN Guideline. SIGN Publication No. 36 ISBN 1899893 76 8 Published March 1999

Orthopaedic Trauma Association Core Curriculum Presentation CoursePowerpoint Presentation made by well known authorities in the area and hosted by the OTA. You may use and edit these presentations for educational purposes provided you give credit to the original author and the OTA

Authors: Peter B. Rauh, FRCS, Matthew C. Solan, FRCS, and Riyaz H. Jinnah, M.D. Orthopaedic patients undergoing lower limb surgery are recognized as a group at especially high risk of DVT/PE. Prevention is therefore of great importance. Treatment of established DVT or PE is beyond the scope of this text. This chapter...

Clinical Signs for DVT:
- exam may be unreliable but positive findings should not be ignored;
- calf tenderness, swelling, fever, & increased pulse rate may be present
- suggestive exam features for pulmonary embolism:
...

Thrombosis is a naturally occurring physiologic process. Under normal circumstances, a physiologic balance is present between factors that promote and retard coagulation. A disturbance in this equilibrium may result in the coagulation process occurring at an inopportune time or location or in an excessive manor. Alternatively, failure of the normal...

40-60% of THR patients who do not receive prophylaxis will get a DVT (dependment on imaging method);
in contrast, the study by Fender et al (JBJS 1997) showed that the incidence of fatal PE (as diagnosed by postmortem examination) was 4 / 2111 patients (0.19%);
Wheeless' Textbook of Orthopaedics

Prophylaxis using heparin and low molecular weight heparin
Heparins and some mechanical pumping devices may help prevent blood clots forming in the legs after surgery for hip fracture
Patients with hip fracture may develop blood clots (thrombosis) in their legs. Some of these blood clots may travel to the lungs and cause...

See links to:
- DVT Discussion
- Pulmonary Embolism
- References
- Role of Dextran in Hip Frx
...

Thromboembolism encompasses two interrelated conditions that are part of the same spectrum, deep venous thrombosis (DVT) and pulmonary embolism (PE). PE is the obstruction of blood flow to one or more arteries of the lung by a thrombus lodged in a pulmonary vessel (see Image 1). PE and DVT can...