Kiran G. Zaveri, MD
Zaveri K.; The Medical Consultant's Role in Caring for Patients with Hip Fracture. Ann Intern Med. 1999;130:76. doi: 10.7326/0003-4819-130-1-199901050-00021
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Published: Ann Intern Med. 1999;130(1):76.
TO THE EDITOR:
Morrison and colleagues' review on the medical consultant's role in the care of patients with hip fracture (1) was very interesting and thorough. Despite this and many other articles, however, prophylactic management of deep venous thrombosis is far from clear. Weight-adjusted low-molecular-weight heparin therapy is probably not necessary, and fixed-dose low-molecular-weight heparin may become standard of practice, as reinforced by Haentjens (2). Although Morrison and associates suggested starting low-molecular-weight heparin before surgery, at present data are limited. Studies are unequivocal, however, about postoperative therapy with enoxaparin sodium (3). Noble and colleagues reported that enoxaparin, 40 mg once daily, started before surgery was more effective than unfractionated heparin, but further studies are needed.
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