Prophylaxis with Intravenous Heparin Therapy for Prevention of Deep Vein Thrombosis Following Femoral Neck Fractures.

Abstract

Thromboembolism is a fatal complication in hip surgery.A variety of pharmacological measures have been proposed for prophylaxis.The purpose of the present study was to compare the rate of bleeding complications in a group of patient who received intravenous heparin therapy with the rate in a control group who received no prophylaxis. 25,000 units of heparin were used by continuous infusion postoperatively.We used ACT (activated clotting time) as a parameter for heparin.ACT is a moderately sensitive screening test for deficiencies in the intrinsic and common pathways of the clotting factor cascade.It is an estimate of the partial thromboplastin time (PPT).ACT was maintained at roughly 200 seconds, almost twice the normal value.Warf arin was begun after the infusion of heparin.The mean transfusion requirement and the mean amount of wound drainage showed no significant differences.There were no instances of wound hematoma and intraocular, retroperitoneal, or intracranial bleeding. We conclude that the use of ACT, enables safe anticoagulant treatment safely.