Thromboprophylaxis with low-molecular-weight heparin in outpatients with plaster-cast immobilisation of the leg

Kock, H. J.; Schmit-Neuerburg, K. P.; Hanke, J; Rudofsky, Gottfried

doi:10.1016/s0140-6736(95)91320-3

Cited by 165 publications

(161 citation statements)

References 5 publications

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“…Comparison with others is, however, difficult since previous randomized studies (Kujath et al 1993, Kock et al 1995, Jorgensen et al 2002, Lassen et al 2002 have included a heterogeneous mix of patients with different lower limb injuries, treated with or without surgery, factors that may influence the effect of the thromboprophylaxis given and the risk of DVT (Geerts et al 2004). Only 1 of the previous studies (Lassen et al 2002) was placebo-controlled and phlebography was mandatory in only 2 of these studies (Jorgensen et al 2002, Lassen et al 2002.…”

Section: Discussionmentioning

confidence: 99%

“…Only 1 of the previous studies (Lassen et al 2002) was placebo-controlled and phlebography was mandatory in only 2 of these studies (Jorgensen et al 2002, Lassen et al 2002. Kujath et al (1993) and Kock et al (1995) used unblinded treatment, and ultrasound to screen for DVT. This method was poorly validated for DVT screening at that time (Wells et al 1995).…”

Section: Discussionmentioning

confidence: 99%

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Prolonged thromboprophylaxis with Dalteparin during immobilization after ankle fracture surgery: A randomized placebo-controlled, double-blind study

et al. 2007

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BackgroundSkeletal trauma and immobilization are well-known risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE). While prophylaxis against thromboembolic complications has become routine after major orthopedic surgery, whether or not prophylaxis after minor surgery and lower limb immobilization is necessary is still under debate.Methods In a double-blind, placebo-controlled study, 272 consecutive patients were randomized to receive either thromboprophylaxis with Dalteparin (n = 136) or placebo (n = 136) for 5 weeks after ankle fracture surgery. All patients received 1 week of initial treatment with Dalteparin before randomization. A unilateral phlebography was performed when the cast was removed.Results The overall incidence of DVT was 21% (95% CI: 13-29%) in the Dalteparin group and 28% (CI: 19-37%) in the placebo group (risk ratio = 0.8, CI: 0.6-1.1; p = 0.3). The incidence of proximal DVTs was 4% and 3%, respectively. No major bleeding occurred.Interpretation We found no significant difference in the incidence of DVT between the 2 treatment groups and our results do not support prolonged thromboprophylaxis. The overall incidence of DVT was high, reflecting the potential risk of PE and post-thrombotic syndrome after ankle fracture surgery. Most of the DVTs were asymptomatic, however, and were located in distal veins.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prolonged thromboprophylaxis with Dalteparin during immobilization after ankle fracture surgery: A randomized placebo-controlled, double-blind study

et al. 2007

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“…[6,[8][9][10][11][12][13][14][15][16][17][18][19][20]26,37,41] A difficulty of long-term follow-up of patients is that many DVT events occur several weeks or longer after discharge. [37,42] …”

Section: Researchmentioning

confidence: 99%

The benefit of pharmacological venous thromboprophylaxis in foot and ankle surgery

et al. 2017

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“…Numerous authors have commented on the proportion of DVTs which arise from the distal calf [10][11][12]. However, there remains debate over the management of distal calf thrombi and the value in treating distal DVT events [13,14].…”

Section: Discussionmentioning

confidence: 99%

Venous Thromboembolism Prophylaxis in Outpatient Lower Limb Fractures and Injuries

Ajwani

Shaw

Naiz

et al. 2016

Ortop Traumatol Rehabil

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Thromboprophylaxis with low-molecular-weight heparin in outpatients with plaster-cast immobilisation of the leg

Cited by 165 publications

References 5 publications

Prolonged thromboprophylaxis with Dalteparin during immobilization after ankle fracture surgery: A randomized placebo-controlled, double-blind study

Prolonged thromboprophylaxis with Dalteparin during immobilization after ankle fracture surgery: A randomized placebo-controlled, double-blind study

The benefit of pharmacological venous thromboprophylaxis in foot and ankle surgery

Venous Thromboembolism Prophylaxis in Outpatient Lower Limb Fractures and Injuries

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