Summary
Disseminated intravascular coagulopathy is a serious complication of numerous pathological conditions, particularly metastatic cancer. It is rarely encountered in orthopaedic surgery. Prompt recognition and treatment is required to prevent death. We describe two patients with pathological fractures of the proximal femur due to metastatic disease who died from disseminated intravascular coagulation after operation. A high index of suspicion, careful monitoring of the clotting mechanism and prompt treatment are required.
Résumé
La coagulation intra-vasculaire disséminée (C.I.V.D) est une grave complication de nombreux états pathologiques et particulièrement des cancers métastatiques. On y est rarement confronté en chirurgie orthopédique. L'évolution se fait vers la mort en l'absence d'un diagnostic précoce et d'un traitement rapidement mis en œuvre. Les auteurs rapportent les observations de deux malades présentant une fracture pathologique d'origine métastatique de l'extrémité supérieure du fémur et qui sont morts de C.I.V.D après l'opération. Ils insistent sur la nécessité d'apprécier les facteurs de risque, de contrôler rigoureusement les mécanismes de la coagulation et d'entreprendre rapidement le traitement.
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Nyska, M., Klin, B., Margulies, J.Y. et al. Disseminated intravascular coagulopathy in patients with cancer undergoing operation for pathological fractures of the hip. International Orthopaedics 11, 179–181 (1987). https://doi.org/10.1007/BF00271444
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DOI: https://doi.org/10.1007/BF00271444