Bone Fractures Should Raise Alert to Blood Clot Risk

A public health official advises that persons who suffer broken bones, especially of the lower leg, ask their physician how to avoid developing a potentially life-threatening blood clot.

The advice is especially appropriate for the high-hazard mining industry.  It is also timely, since a contract worker at an Indiana coal mine construction site died May 24 after a blood clot ended up in his lungs.  He had been convalescing at home from a broken leg suffered on the job nine days earlier.

According to the CDC’s Dr. Scott Grosse, anyone is at risk of developing a blood clot, but the risk is especially high after lower leg bone fractures. The risk is higher still if the victim has to wear a cast, because the leg is immobilized. 

Grosse said the doctor may prescribe a blood thinner or use of a compressive stocking.  The physician may also suggest watchful waiting; i.e., being alert for persistent symptoms such as tenderness, pain or swelling.  If the clot is in the lung, there could be shortness of breath or pain.  In any of these situations, medical attention should be sought at once, Grosse said.  However, a blood clot may not produce symptoms, he cautioned.

A blood clot in a deep vein is known as deep vein thrombosis.   A pulmonary embolism develops if the clot breaks free and enters the arteries of the lungs, as happened with the Indiana contract mine worker.

If an individual is hospitalized with a bone fracture, a compression device may be attached to the legs as a clot preventative measure.  It delivers a pulse, presumably to improve circulation.  However, since it is electrical, it cannot be worn when a patient is walking around, nor is it intended for use at home.

Grosse noted that you don’t have to have a broken bone to get a blood clot.  A risk factor is age; those over 40 are at higher risk and the risk increases with increasing age.  In addition, other risk factors include excessive body weight; a personal or family history of blood clots; major operations; certain medical conditions (besides fractures), such as but not limited to cancer and cancer treatment, strokes, paralysis, and varicose veins; pregnancy; some oral contraceptives; smoking; and prolonged inactivity.

To reduce risk if you are sitting for long periods, such as on an airplane for over four to five hours, get up periodically and move around.  If that’s not possible, perform leg exercises while seated, such as squeezing your calf muscles, pointing and flexing your feet and wiggling your toes. Avoid crossing your legs, keep away from alcohol and stay hydrated.

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