Hip fracture: heparin is for thromboembolic prophylaxis

doi:10.1136/bmj.333.7559.147-c

BMJ 2006;333:147 (15 July), doi:10.1136/bmj.333.7559.147-c

Letter

Hip fracture: heparin is for thromboembolic prophylaxis

The first 150 words of the full text of this article appear below.

EDITOR—Thromboembolic prophylaxis for hip fracture iscontentious, as Parker and Johansen state in their review ofhip fracture.¹ Well might eyebrows be raised, however, by theirfailure to recommend any form of low molecular weight heparinthromboprophylaxis contrary to the latest American and Britishguidelines.² The current debate, driven by epidemiological dataand recent clinical trials, is not the benefit of low molecularweight heparin preparations at proved doses but the likely inadequacyof typical courses of five to 10 days compared with longer andmore inconvenient courses of 28 days or more.³

The authors further seem to imply that with heparin it is bestto give nothing because of the risk of bleeding complications.Their referenced 2002 Cochrane review states there is a lackof power to identify outcomes of clinical importance apart froma reduction in deep vein thrombosis. There are currently concernsabout wound infection . . . [Full text of this article]

Michael L Jenkinson, consultant physician

Queen Elizabeth, The Queen Mother Hospital, Margate, Kent CT9 4AN mljenkinson@ekht.nhs.uk