Submassive pulmonary embolism and muscular calf vein thrombosis after complicated hip fracture.

The clinical relevance of distal deep vein thrombosis is discussed controversly. A 26-year-old man presented with dyspnea on exertion and pleuritic pain since the day before. Five weeks ago, he sustained multiple fractures at an accident--among others a complicated hip fracture needing screw fixation. He stopped the antithrombotic prophylaxis three days before admission. Our examinations showed calf muscle vein thrombosis and submassive bilateral pulmonary embolism. Due to our own clinical experiences, we support an anticoagulation treatment with compression therapy for isolated calf muscle vein thrombosis in patients with coexisting risk factors for venous thromboembolism.