The week-old hip fracture: indication for prophylactic use of a vena cava filter? Report of two cases.
Occasional patients will present a week or more after sustaining a hip fracture. Though these patients are at high risk for asymptomatic deep venous thrombosis and pulmonary embolism, anticoagulation may be contraindicated prior to surgery. Two recent cases involving such a situation are reported. In the first, the patient sustained a fatal intraoperative pulmonary embolism. In the second, a transvenous Greenfield vena caval filter was placed prior to surgery. An extremely high suspicion of asymptomatic deep venous thrombosis is necessary when evaluating a patient whose hip fracture has been untreated for a week or more. If studies demonstrate a deep venous thrombosis preoperatively, placement of an inferior vena caval filter may be indicated.
D000368:Aged; D005260:Female; D006620:Hip Fractures / Q000150:complications*; D006801:Humans; D008297:Male; D013924:Thrombophlebitis / Q000209:etiology / Q000517:prevention & control*; D014684:Venae Cavae