July/2006

ANSWER  9 =C

DISCUSSION:

Antibiotic prophylaxis is recommended to prevent infection after hip fracture surgery. However, antibiotic prophylaxis is usually initiated within the two hours before surgery14 and is continued for only 24 hours after surgery. Thromboembolic complications cause significant morbidity and mortality in patients undergoing hip fracture surgery. Without prophylaxis, the rate of total deep venous thrombosis (DVT) in these patients is approximately 50 percent, and the rate of fatal PE is 1.4 to 7.5 percent. Guidelines from the American College of Chest Physicians6 recommend thromboprophylaxis for at least 10 days after surgery for patients with hip fracture. Rehabilitation is essential after hip fracture. Prolonged bed rest can increase the risk of pressure sores, atelectasis, pneumonia, deconditioning, and thromboembolic complications. Weight bearing immediately after hip fracture surgery is safe in most patients. See http://www.aafp.org/afp/20060615/2195.html.