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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 8,
1117-1122.
doi: 10.1302/0301-620X.87B8.15680 Copyright © 2005 by British Editorial Society of Bone and Joint Surgery Continuous passive motion in the prevention of deep-vein thrombosisA RANDOMISED COMPARISON IN TRAUMA PATIENTSS. Fuchs, MD, PhD, Professor, Orthopaedic Surgeon1; T. Heyse, MD, Resident, Orthopaedic Surgery1; G. Rudofsky, Professor, Angiologist2; G. Gosheger, MD, PhD, Professor, Orthopaedic Surgeon1; and C. Chylarecki, MD, Trauma Surgeon3
1 Department of Orthopaedic Surgery, WW-University of Münster, Albert-Schweitzer-Strasse 33, 48149 Münster, Germany. Correspondence should be sent to Dr. T. Heyse at Offenbergstrasse 10, 48151 Münster, Germany; e-mail: heyset{at}uni-muenster.de
There is a high risk of venous thromboembolism when patients are immobilised following trauma. The combination of low-molecular-weight heparin (LMWH) with graduated compression stockings is frequently used in orthopaedic surgery to try and prevent this, but a relatively high incidence of thromboembolic events remains. Mechanical devices which perform continuous passive motion imitate contractions and increase the volume and velocity of venous flow. In this study 227 trauma patients were randomised to receive either treatment with the Arthroflow device and LMWH or only with the latter. The Arthroflow device passively extends and plantarflexes the feet. Patients were assessed initially by venous-occlusion plethysmography, compression ultrasonography and continuous wave Doppler, which were repeated weekly without knowledge of the category of randomisation. Those who showed evidence of deep-vein thrombosis underwent venography for confirmation. The incidence of deep-vein thrombosis was 25% in the LMWH group compared with 3.6% in those who had additional treatment with the Arthroflow device (p < 0.001). There were no substantial complications or problems of non-compliance with the Arthroflow device. Logistic regression analysis of the risk factors of deep-vein thrombosis showed high odds ratios for operation (4.1), immobilisation (4.3), older than 40 years of age (2.8) and obesity (2.2). This article has been cited by other articles:
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