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KMID : 1028220170290030159
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Hip & Pelvis
2017 Volume.29 No. 3 p.159 ~ p.167
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Recent Updates of the Diagnosis and Prevention of Venous Thromboembolism in Patients with a Hip Fracture
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Shin Won-Chul
Lee Sang-Min
Suh Kuen-Tak
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Abstract
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Venous thromboembolism (VTE) is a potentially fatal complication that is relatively common after hip surgery. Since patients with a hip fracture have a higher risk of preoperative VTE due to an inability to ambulate after injury and aggravation of underlying age-related conditions, it may be difficult to effectively prevent VTE using only conventional approaches. Very few studies have been published reporting on the prevalence and prevention of VTE in patients with a hip fracture compared to those with hip arthroplasty. For this reason, we aimed to share recent updates on the diagnosis and prevention of VTE in patients with a hip fracture. Preoperative screening tests to diagnose VTE need to be performed more actively following hip fracture and indirect multidetector computed tomography venography is considered the most effective test for this purpose. As the risk of VTE appears to increase with time following a hip fracture, preventive measures should be taken as soon as possible in patients with a hip fracture. A wide variety of mechanical and pharmacological options are available for prophylaxis. When considering patient compliance and preventive impact, intermittent pneumatic compression devices and foot pumps are recommended as mechanical modalities. Of the available preventive medications for patients with a hip fracture, low molecular weight heparin seems to be the most appropriate option because of its short half-life and fast onset of action. Surgery should be performed as soon as possible in patients with hip fractures, and we recommend mechanical and pharmacological methods as active interventions immediately after injury to prevent VTE.
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KEYWORD
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Hip fractures, Venous thromboembolism, Diagnosis, Prevention
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