The aim of this study was to evaluate any possible benefits of early thromboprophylactic treatment in the prevention of deep vein thrombosis (DVT) in high-risk hip fracture patients. Within 30 months, 239 patients were included in a double-blind placebo-controlled study. With the diagnosis of hip fracture confirmed, patients received either 40-mg Enoxaparin s.c. or placebo once daily until operation. Postoperatively, all patients received 40-mg Enoxaparin s.c. once daily until phlebography. Phlebography was first performed on the operated leg, and with no thrombosis detected, the other leg was investigated as well. The two groups did not differ demograph-ically. Eighty-five patients were excluded. Eight patients died during the study period. The remaining 146 patients had ascending phlebography performed and 24 patients (16.4%) developed DVT. Nine (12%) of 75 patients in the Klexane® and 15 (21 %) of 72 patients in the placebo group developed DVT.The risk ratio was 0.58 (95% confidence limits 0.27-1.25) and p = .15 (X2 test). There was no difference in perioperative bleeding or transfusion requirements. We conclude that Klex-ane® is an effective and safe thromboprophylactic agent in hip fracture patients.
During a 10 year period 58 patients had 80 trigger fingers operated on at this hospital. The male/female ratio was 32:26 and most children were operated on at between the ages of 2 and 4 years, and 15 months (range 2-99) after the lesion had been noticed. The operation was quick and effective with no complications. Only one patient was re-operated on, with a good result. Thirteen patients had bilateral lesions. Both hands were examined and in 11 patients (19%) we found that the thickening corresponding to the trigger finger was also present on the opposite side but giving no symptoms. There seems to be a predisposition to bilateral affections.
Venous US is less sensitive as a test for DVT in this study of asymptomatic patients than in earlier studies on symptomatic patients. Still, sonographic screening of high-risk patients would be both effective and cost effective. Fresh thrombi may cause a false-negative compression test.
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