ABSTRACT
Deep vein thrombosis (DVT) occurs in 80% of patients undergoing major orthopaedic surgery (e.g. hip fracture or hip and knee replacement), and pulmonary embolism (PE) in 10%, if prophylaxis against thromboembolism is not undertaken. DVT is the commonest cause of emergency re-admission to hospital after total hip replacement. Most fatal emboli arise from deep vein thrombosis in the lower limb. The most effective way to prevent thromboembolic disease is to use routine prophylaxis for patients at risk. The risk of venous thromboembolism increases exponentially with age and becomes appreciable at 40 years with major illness, trauma or surgery. Other risk factors include obesity, immobility, previous DVT or PE, and malignancy. Patients with previous thromboembolic episodes have a postoperative risk of DVT greater than 50%.
