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Clinical inquiries. Does anticoagulation prevent thrombosis for persons with fractures distal to the hip?
Julie Brogen1, Gary Kelsberg, Sarah Safranek
1Valley Family Medicine Residency, Renton, WA, USA. Julie_Brogren@valleymed.org
Abstract:
Low-molecular-weight heparin (LMWH) prophylaxis significantly reduces the total incidence of deep venous thrombosis (DVT) for patients with lower-limb fractures managed with surgical fixation and cast immobilization (strength of recommendation [SOR]: A, based on multiple randomized controlled studies [RCTs]). Evidence is insufficient to show whether LMWH specifically reduces the risk of clinically significant DVTs, and recommendations on its use are conflicting (SOR: C, based on expert opinion). Evidence is insufficient to recommend for or against warfarin prophylaxis for DVT in fractures distal to the hip (SOR: C, based on expert opinion).
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