[An update on thrombosis prophylaxis in orthopaedic and accident surgery]

The prevention of deep venous thrombosis has become a routine in orthopaedic surgery. While the necessity for prophylaxis is not questioned, its practice is still a matter of controversy. The development of new anticoagulants increases the variety of prophylactic methods but leads to a need for additional information. This review deals with the indications for thrombosis prophylaxis in relation to exposing and predisposing risk factors. The currently available modalities of prophylaxis, their pharmacological details and clinical significance are presented. Evidence based data, recommendations on the duration of prophylaxis derived from official guidelines, issues of the cost/effectiveness, and medico-judicial aspects are discussed.