Altered venous function and deep venous thrombosis following proximal femoral fracture

Increased risk of stroke among hip fracture patients: a nationwide cohort study

“…Antihypertensive medications were associated with an increased risk of hip fracture [25]. The findings of this study also indicate that using diuretics and ABRs concurrently increases the risk of stroke, which might be related to the dehydration and hypercoagulative status of patients after hip fracture, which is a documented complication that can trigger a stroke [26]. This study did not investigate the impact of the type of hip fracture, anesthesia, or surgery.…”

Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link?

“…Factors that reportedly contribute to this period of hypercoagulability are trauma at the initial injury, subsequent surgery, blood loss secondary to the fracture and at surgery, and fluid resuscitation before and after surgery. (13,14) Given these controversies, we reviewed and compared the incidence of DVT and progression to PE in cemented versus uncemented hemiarthroplasty in this population of patients predisposed to hypercoagulability.…”

“…(11,12) Notably, all of these studies (6)(7)(8)(9)(10)(11)(12) used healthy patients for elective surgery, while patients with traumatic femoral neck fractures are potentially in a procoagulable state due to the nature of the trauma sustained in the initial injury. (13,14) In addition, several recent studies have reported on the possible thrombogenic properties of polymethyl methacrylate cement and the activation of platelet aggregation and cytokines, which could contribute to the pathogenesis of DVT. (15)(16)(17) With this background of controversy, we aimed to review and compare the incidence of DVT and its progression to pulmonary embolism (PE) or mortality in cemented versus uncemented hemiarthroplasty for traumatic displaced femoral neck fractures.…”

The ‘‘Critical Thrombosis Period’’ in Major Orthopedic Surgery: When to Start and When to Stop Prophylaxis

“…There is often disruption to blood flow in the femoral vein and debris might be present in a patient's blood. [22][23][24] Slow, turbulent blood flow in valve cusps creates local areas of stasis and encourages the development of thrombi. 23 During surgery, there is a significant reduction in both venous outflow and venous capacitance.…”

“…23 During surgery, there is a significant reduction in both venous outflow and venous capacitance. 24 After orthopedic surgery, DVT events are mostly concentrated in the operated leg, emphasizing the role of stasis. 25,26 Local tissue damage associated with surgery is also an important factor in proximal thrombosis, 25 and it is recognized that surgical technique can affect both operative venous stasis and the risk of thrombi formation.…”