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Thromboprophylaxis in Intramedullary Limb Lengthening Surgery
Alexios D Iliadis1, Anna Timms1, Sharron Fugazzotto1
1Limb Reconstruction Unit, Royal National Orthopaedic Hospital NHS Trust, Stanmore, United Kingdom.
Strategies in Trauma and Limb Reconstruction
|May 24, 2021
Summary
Intramedullary lengthening surgery is increasingly popular. Current thromboprophylaxis practices vary widely, with limited data to guide venous thromboembolism prevention in patients.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Medical Device Technology
Background:
- Intramedullary lengthening devices are gaining popularity for limb reconstruction.
- Limited data exist on venous thromboembolism (VTE) incidence and thromboprophylaxis in these procedures.
- Post-operative VTE necessitates evaluating current practices and developing guidelines.
Purpose of the Study:
- To assess current thromboprophylaxis practices for adult intramedullary limb lengthening in the UK.
- To determine the incidence of VTE following these procedures.
- To inform the development of consensus guidelines for safe practice.
Main Methods:
- A national online survey was distributed to UK surgeons performing adult intramedullary limb lengthening.
- Data on thromboprophylaxis regimens and VTE cases were collected.
- The British Limb Reconstruction Society and Precise Users database were used for surgeon identification.
Main Results:
- 24 of 54 surveyed surgeons responded, reporting on 454 adult intramedullary lengthening cases (2015-2020).
- Only one case of deep vein thrombosis (DVT) after femoral lengthening was reported.
- Significant variability exists in VTE risk assessment, prophylaxis choice, and duration, with 85% of surgeons lacking sufficient evidence.
Conclusions:
- Intramedullary lengthening surgery is increasing, but evidence for thromboprophylaxis remains limited.
- Current practices for VTE prevention are highly variable among surgeons.
- There is a clear need for data-driven consensus to guide safe and effective thromboprophylaxis.
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