Postoperative deep venous thrombosis among patients undergoing neck of femur fracture surgery: a retrospective cohort analysis

Background: Surgical options for neck of femur fracture (NFF) include open reduction and internal fixation (ORIF) or arthroplasty (hemiarthroplasty, HA or total hip arthroplasty, THA). The choice is based on several variables with each modality having distinct advantages and disadvantages. Previous studies have shown that ORIF may be a protective factor in the development of postoperative deep vein thrombosis (DVT) compared to arthroplasty. However, there is significant variation in methodology, results and limited follow up. Objective: This study aimed to investigate whether ORIF is a protective factor for postoperative DVT compared to arthroplasty with follow up of patients for up to 3 months. Methods: Retrospective chart review study of patients who had NFF, were 60 years or older and underwent surgical intervention between January 2020 and May 2023. Clinical and demographic characteristics were recorded and analyzed. DVT rates were compared between ORIF and arthroplasty. This was repeated for ORIF vs HA vs THA. Results: Among 161 NFF patients, 1 (3.7%) of ORIF patients developed DVT versus 2 (1.44%) of arthroplasty. This difference was not significant, no patients in the THA (n=5) group developed DVT. Conclusion: The number of postop DVT observed was likely underestimated as only symptomatic DVT was assessed, population size was less than expected and the vast majority of patients underwent arthroplasty. Larger, multicenter studies with 3-month follow-up are required to determine whether ORIF may be a protective factor in developing DVT.