Low molecular weight dextran to prevent venous thrombosis after elective surgery of the hip

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THROMBOEMBOLISM is one of the most frequent and dangerous of the complications that occur in the orthopaedic patient not only after trauma, but also after elective surgery of the hip. Evidence is mounting to indicate that there is a rapidly increasing real incidence of this problem.1 Prevention of thromboembolic disease by a safe method is preferable to treatment instituted after the disease has developed. The threat of venous thrombosis is greater with the increasing age of patients and with the more complicated and extensive operative procedures. The limitations of the clinical examination and the recognition of deep venous thrombosis deserve further emphasis; many “silent” thromboses occur. The use of preoperative and postoperative venography has demonstrated that venous thrombosis develops in almost 50 percent of the patients.2

The high incidence of venous thrombosis in patients undergoing elective surgery of the hip was the reason for investigating this problem. Our preliminary report describes a controlled study of the incidence of venous thrombosis after elective surgey of the hip, and the efficacy and safety of its prevention by the infusion of low molecular weight dextran. If low molecular weight dextran proves to be effective in decreasing thromboses and thromboembolic complications in patients undergoing elective surgery of the hip, it will be preferable to the use of anticoagulants.3

Materials and methods

In a controlled study of 39 patients who were to undergo elective surgery of the hip, preoperative venograms of the lower extremities were obtained. According to sealed instruction, not known to the surgeons, . . .



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