Hong Kong Journal of Orthopaedic Surgery

Volume 5 Number 2, October 2001
Abstract

Managing of supracondylar femur fracture in a patient with congenital antithrombin III deficiency

Wong KC, Leung KS
Department of Orthopaedics and Traumatology, Prince of Wales Hopsital, Chinese University of Hong Kong, Hong Kong.

Congenital antithrombin III deficiency is associated with increased risk of thromboembolism. Here we report the case of a Chinese accident victim with congenital antithrombin III deficiency who sustained a supracondylar fracture of the left femur and subsequently developed deep vein thrombosis in the injured leg. The resulting thrombosis altered our approach to the postoperative management of her fracture. Thromboprophylaxis was initially done through the pre- and postoperative administration of fresh frozen plasma in addition to perioperative use of the anticoagulant heparin. Four days after the femur fixation operation, when deep vein thrombosis was discovered, we ordered antithrombin III replacement therapy in this patient until her full remobilization. Use of antithrombin III concentrate for prophylactic anticoagulation treatment has a relatively lower risk of fluid overload than does therapy with fresh frozen plasma, and the former allows more accurate estimation of antithrombin III levels. (Hong Kong Journal of Orthopaedic Surgery 2001;5(2):125-128.)

Key Words : Aged, Anticoagulants/therapeutic use, Antithrombin III deficiency / complications, Biosynthesis, Thromboembolism / congenital

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