Eskander MB, Limb D, Stone MH, Furlong AJ, Shardlow D, Stead D, Culleton G.
Sequential mechanical and pharmacological thromboprophylaxis in the surgery of hip
fractures. A pilot study.
Int Orthop 1997;21(4):259-61

Academic Department of Orthopaedic Surgery, General Infirmary, Leeds, UK.

Two hundred and thirty-eight patients with femoral neck fractures were entered
into a randomised pilot study comparing the use of sequential treatment by
'Flowtron DVT' garments in the perioperative period followed by Enoxaparin
(Clexane-Rhone-Poulenc Rorer), and Enoxaparin alone. One hundred and ninety-three
patients were excluded indicating the difficulty of achieving pure comparisons in
this population. The remaining 44 were randomised: 21 received Enoxaparin from
the time of admission, and 23 had sequential treatment. There was no
statistically significant difference in the incidence of thromboembolism. Patient
preference did not indicate a favoured treatment subjectively. The operation
field was drier in the sequential group, although this did not reach
significance. Sequential treatment was not shown to be better or worse than
treatment with Enoxaparin, but the trends favoured sequential treatment rather
than drug treatment alone. The technique allows the operation to be carried out
without the problems produced by low dose heparins and mobilisation is not
hindered by compression garments.