Thrombophylaxis after surgical fracture repair

Interventions to reduce venous thromboembolism in patients who have undergone surgery for fractures fall into two categories: mechanical prophylaxis with antiembolism stockings and intermittent pneumatic compression device; and pharmacologic prophylaxis, including aspirin, direct anticoagulants, and injectable low molecular weight heparin.

In a trial of 12,211 participants, the Major Extremity Trauma Research Consortium treated participants 18 years of age or older treated operably for a limb fracture or any pelvic or acetabular fracture with low molecular weight, heparin or aspirin 81 mg b.i.d.: occurrence of death were similar at 90 days.

In this study, the risk of pulmonary embolism was similar, and there was no difference in incidence of bleeding events.

The incidence of DVT was higher in the aspirin group at 2.51% versus 1.71% in the low molecular heparin group.

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