Abstract
Pulmonary Thromboembolism (PE) is one of serious complication in orthopaedic patients. Unfortunately, diagnosis of PE at early stage is difficult. Therefore, clear standards have been established as the Japanese Guideline for preventing PE. We reported two cases of PE out of 504 patients with hip fractures.
Case 1: A 65-year-old woman with obesity and hypertension sustained a left femoral neck fracture. She had undergone direct traction, and 13 days later she underwent an operation. In operation, her blood pressure suddenly fell. She was presented to the emergency room and she was immediately treated with tPA and heparin.
Case 2: A 75-year-old woman with obesity and diabetes sustained a right femoral trochanteric fracture. Nine days following the initial injury, she underwent an operation. The SpO2 suddenly dropped the next day. The angiographic study revealed PE in the pulmonary artery. She was treated using tPA and heparin.
Because obesity and long-term confinement to bed are preoperative risk factors for PE, anticoagulant therapy or intermittent pneumatic compression treatment should be considered to prevent PE. In this paper we argued that the most important approach to prevent PE would be to put more efforts into early diagnosis for PE.
