Deep vein thrombosis following hip fracture surgery

Patients undergoing hip fracture surgery are at increased risk of deep vein thrombosis. There are limited studies of good quality assessing thromboprophylactic therapies in this patient population. Mechanical pumping devices may have a role in hip fracture patients, especially around the perioperative period, though compliance with these devices is a significant problem. Fondaparinux is the most effective pharmacological thromboprophylactic therapy following hip fracture surgery and can be used for extended prophylaxis after hospital discharge. A number of the recently published recommendations from the National Institute for Health and Clinical Excellence do not take into account the best available evidence specifically in patients undergoing hip fracture surgery, with findings from elective arthroplasty patients being extrapolated. Well-designed randomised trials are needed to determine the role of combined thromboprophylaxis, graduated compression stockings and newer oral anticoagulants so that appropriate recommendations can be made in patients undergoing hip fracture surgery.