Advice on treatment for HIP FRACTURE by accident.

Resolved Question:

Hi.

My husband had surgery last Tuesday night on his hip for a fracture from a biking accident. I'm attaching an xray. We are American but living in Thailand. The surgeon gave him clearance to travel so we are flying to Hong Kong tomorrow (about 11 days after his surgery) and then from Hong Kong to the U.S. (about a 15 hour flight) on September 7th. Although the doctor gave him clearance to travel he did not prescribe any blood thinners. I don't totally trust the fact that he doesn't need them as the Thai medical system is different from U.S. I bought him a compression sleeve for his injured leg that spans from his upper ankle to above his knee but wanted to see if you... A) think it's ok that he does this long flight 11 days after his surgery and B) recommend any over the counter blood thinners (such as asprin) for him to take before and during flight. I also want to make sure asprin (if you recommend it) wouldn't conflict with any of the other pain med and antibiotics that were given to him post surgery.

Your advice would be greatly appreciated.

I look forward to hearing from you.

Vera


Category: Orthopedic Surgeon

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Category: Spine Surgeon
Dr. Karun Jain is online now

Expert:  Dr. Karun Jain replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
Thanks for writing to us.
I have read your details. Let me give you few recommendations, if you are travelling within 4 weeks post hip surgery by plane.
The factors that raise the risk of blood clots during air travel are long immobilization, dehydration, obesity, being very tall or very short (over 6-foot-2 or shorter than 5-foot-2), use of oral contraceptives and inherited blood disorders, according to the WHO.
The low humidity on planes further increases dehydration risk.
Although staying home is the best way for recent surgery patients to minimize their risk of blood clots, several newly developed prescription blood thinners are available and help reduce the danger of clotting in some patients who insist on going on the travel before the risk has leveled. All blood thinners, however, are powerful medications and should be taken only after your physical examination & you’ve weighed the benefits and risks, better to take only after discussing with your treating doctor.
Asprin can be taken but as such has no well documented role in preventing DVT in post surgery travellers.
Here are some ways to reduce the risk of blood clots:
?Avoid travel for at least a month after surgery, if possible.
?Move as much as possible during the trip. If you’re traveling by plane, bus or train, stand, stretch and walk down the aisles and stretch at least every three to four hours.
?Promote blood circulation by exercising the calf muscles with up-and-down movements of the feet at the ankles.
?Wear compression stockings, which are designed to increase blood flow in the legs.
?During travel, avoid tight clothing and shoes that can impede circulation.
?Stay hydrated by drinking lots of water and avoid alcohol and caffeinated beverages.
I hope my opinion will help you.
Stay happy & healthy,
Thanks


Patient replied :

Thank you for your reply. My husband is tall. He's 6ft 4in. If he wears the compression sleeve, excercises his leg regularly while seated, gets up to walk/stretch every 2-3 hours, avoids caffine and alcohol, stays hydrated and takes asprin, how would you rate your concern level with flying on a scale from 1-10? I'm just trying to get a sense of whether or not this is a serious concern or a concern that can be greatly reduced if taking the necessary precautions.
Thanks again for your help.
Vera


Expert:  Dr. Karun Jain replied 3 Days.

Thanks for writing back to us.
If you take necessary precautions, chances of DVT are quite less; Say around 1 in 10,000 as per literature.


Dr. Karun Jain
Category: Spine Surgeon
Experience: 
MBBS, 2002 - Kasturba Medical College, Mangalore
D.Orth, 2009- J.S.S Medical College, Mysore
MS - Orthopaedics, 2011 - University of Seychelles - American Institute of Medicine
Currently pursuing ChM (Trauma & Orthopedics) from The Royal college of Surgeons, Edinburgh & University of Edinburgh, U.K
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