{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:16Z","timestamp":1787755576208,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We present a case of acute disseminated intravascular coagulation (DIC) after prophylactic femoral intramedullary stabilization in a patient with metastatic prostate cancer. Preoperative international normalized ratio of 1.4 was attributed to malnutrition, and the patient was not medically optimized. DIC developed 1 hour postoperatively and was managed with blood product resuscitation. At the 4-month follow-up, the patient presented with bilateral pulmonary emboli and was transitioned to palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>DIC after intramedullary stabilization in patients with metastatic bone disease is a rare condition with high mortality rate. Early recognition, blood product resuscitation, and involvement of appropriate subspecialty services are imperative in DIC management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.19.00370","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T13:24:22Z","timestamp":1580736262000},"page":"e0370-e0370","source":"Crossref","is-referenced-by-count":1,"title":["Acute Disseminated Intravascular Coagulation After Prophylactic Nailing of the Femur in a Patient with Metastatic Prostate Cancer"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6853-4525","authenticated-orcid":false,"given":"Daniel Z.","family":"You","sequence":"first","affiliation":[{"name":"Section of Orthopaedic Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada"},{"name":"McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9440-2294","authenticated-orcid":false,"given":"Joseph K.","family":"Kendal","sequence":"additional","affiliation":[{"name":"Section of Orthopaedic Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada"},{"name":"McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-9930","authenticated-orcid":false,"given":"Paul","family":"Duffy","sequence":"additional","affiliation":[{"name":"Section of Orthopaedic Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada"},{"name":"McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9517-8308","authenticated-orcid":false,"given":"Michael J.","family":"Monument","sequence":"additional","affiliation":[{"name":"Section of Orthopaedic Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada"},{"name":"McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2653-6503","authenticated-orcid":false,"given":"Prism S.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Section of Orthopaedic Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada"},{"name":"McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020]]},"reference":[{"key":"bib1-20230720","doi-asserted-by":"crossref","first-page":"16037","DOI":"10.1038\/nrdp.2016.37","article-title":"Disseminated intravascular coagulation","volume":"2","author":"Gando","year":"2016","journal-title":"Nat Rev Dis Primers."},{"key":"bib2-20230720","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1097\/01.blo.0000093045.56370.dd","article-title":"The classic: metastatic disease in long bones A proposed scoring system for diagnosing impending pathologic fractures","volume":"415","author":"Mirels","year":"2003","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib3-20230720","first-page":"1210","article-title":"Arterial oxygenation can fall critically during intramedullary nailing of pathological femoral fractures","volume":"69","author":"Karanko","year":"2010","journal-title":"J 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