Abstract
Introduction: Venous Thromboembolism (VTE) and Pulmonary Embolism (PE) are more common following orthopaedic surgeries around the hip than other surgeries. However, there is still a dilemma among orthopaedic surgeons regarding whether routine thromboprophylaxis is justified in patients. Aim: To describe current practices among orthopaedic surgeons regarding routine thromboprophylaxis among patients with proximal femur fractures. Materials and Methods: A cross-sectional exploratory study was conducted at Department of Orthopaedics, Saveetha Medical College, Chennai, Tamil Nadu, India between March 2022 and May 2022 among orthopaedic surgeons. A Google survey form, containing 10 prevalidated multiple-choice questions, was shared on social media and medical groups. Descriptive analysis was undertaken, and statistical analysis was done with International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) software version 28.0. Results: Among the 141 respondents, 72% were from private sector institutions/hospitals. Over 90.78% of the respondents indicated that there was a role for anticoagulation therapy in proximal femur fractures, and 92% used low molecular weight heparin. The responses varied slightly depending on whether anticoagulant treatment was used preoperatively (51%) or postoperatively (48%), and if there was a waiting time of less than 24 hours to 3-5 days before surgery. Most orthopaedic surgeons opted for anticoagulation therapy in the presence of a previous history of Deep Vein Thrombosis (DVT)/PE (79%), age greater than 70 years (61%), and use of hormone replacement therapy (64%), or if the surgery lasted more than two hours (61%). Conclusion: The present study concludes that 9.2% of orthopaedic surgeons do not use anticoagulation therapy and nearly half (48%) do not administer anticoagulation therapy preoperatively. As the proportion of elderly patients increases, consensus building will enable the formulation of practice guidelines based on evidence generated through such surveys.
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