| Background and objectives:Deep venous thrombosis(DVT)is a blood clot(thrombus)formation or abnormal mass of blood clot formation within a deep vein of the lower extremity or pelvis.It’s significant cause of morbidity,disability,discomfort and death after trauma-associated hospitalization.Proximal femoral fractures include:Intra capsular fracture which occur at the level of the neck and the head of femur,and are generally within capsule.Extra capsular fracture which is intertrochanteric fracture that arises between the femoral neck and the lesser trochanter.Intertrochanteric fractures usually cross between the lesser trochanter and the greater trochanter.The trochanters act as major attachment points for the hip muscles.Lower extremity fractured patients and those who undergoing major orthopedic surgery were found to have the highest operative risk group for DVT.The high rates in these patients light up the accumulation and presence of multitudinous conditions that accelerate and promote the development of DVT,which are endothelial or vessel wall injury,immobility,and activation of coagulation pathways as mentioned in Virchow’s triad.The risk factors strongly increases with major orthopedic surgery,general surgery,pelvic fracture,hip fracture,long bones fracture,multiple trauma,previous DVT,malignancy,myocardial infarction,and other congenital risk factors as protein C and S deficiencies and antithrombin.It can be complicated with life threatening conditions like pulmonary embolism as well as long standing complication of post thrombotic syndrome.To prevent these critical conditions immediate diagnosis is required by following the new strategies developed including pretest probability using well’s score,D-dimer and venous imaging.The general risk of DVT might be decreased by prophylaxis.Mechanical and/or pharmacological modalities are required as strategy for prevention of DVT which can be used alone or in combination.The ideal duration of thromboprophylaxis is not known which depends on the level of risk of DVT.Patients subjecting to major hip operation or total hip arthroplasty may require prolonged thromboprophylaxis more than 10 days and up to 35 days particularly for patients with high risk of DVT,even though in patients admitted with acute medical illness thromboprophylaxis should be continued until send home and discharge.The objective of this study is to revise the current understanding regarding the morbidity of the DVT in the proximal femoral fracture and to evaluate the incidence of DVT in trauma patients with femur neck and intertrochanteric fractures. |
