Summary
Evidence from one randomized controlled trial suggests that for hip fracture patients,
short-term heparin-type prophylaxis with an extended duration of 4 – 6 weeks for prevention
of venous thromboembolitic events leads to significantly lower venous thromboembolism
(VTE) than in those given a placebo following a short-term prophylaxis. In patients
with ankle fractures, VTE was less frequent for short-term plus extended prophylaxis
versus the short-term plus placebo, but differences were not statistically significant.
Overall mortality rates were not significantly affected by prophylaxis status in either
study, but extended treatment with fondaparinux following the short-term course after
hip fractures resulted in slightly higher rates of major bleeding compared with those
receiving the short-term course followed by placebo. Additional trials are needed
to confirm these results.
