Thromboembolism following hip fracture.

Two hundred forty-eight patients following hip fracture were studied for deep venous thrombosis and pulmonary embolus. Ventilation-perfusion lung scans and contrast ascending venography were performed on the sixth to eighth postoperative days. Low-dose intravenous heparin (3,000-5,000 units every 6 hours) was followed by a decreased incidence of pulmonary embolism more than twofold. Although heparin administration was not associated with a significantly decreased incidence of deep venous thrombosis as assessed by venographic studies, thrombi in the nonheparin-treated patients were more likely to occur above the knee and were at higher risk for pulmonary embolus. Pneumatic and mechanical compression devices alone did not protect patients from deep venous thrombosis above the knee, but were associated with a decreased incidence of pulmonary embolus compared to control.