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Trauma: S. Patil, J. Gandhi, I. Curzon, and A. C. W. Hui Incidence of deep-vein thrombosis in patients with fractures of the ankle treated in a plaster cast J Bone Joint Surg Br 2007; 89-B: 1340-1343 [Abstract] [Full text] [PDF]

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Is there a case for not giving thromboprophylaxis for ankle fractures?

Adnan A Faraj   (1 February 2008)

Is there a case for not giving thromboprophylaxis for ankle fractures? 1 February 2008
Adnan A Faraj, doctor orthopaedics Send letter to journal: Re: Is there a case for not giving thromboprophylaxis for ankle fractures? shevanfaraj{at}hotmail.com Adnan A Faraj	Sir, I read this paper with interest, however, I am not sure the conclusions from this paper are justified. There are 100 patients included in this paper, there are no strict inclusion and exclusion criteria, and the statistical analysis is not complete. Some of these patients were on Aspirin. Only high body mass index and smoking have been studied as risk factors for deep venous thrombosis (DVT), but there are more in the NICE guidelines. Ultrasonography is performed in this study by a technician to investigate DVT. The gold standard is considered to be venography.1 To make sense of a study concerning DVT and pulmonary embolism (PE), it is thought that an appropriate randomised, prospective study with a large number of patients using overall mortality and fatal PE rates as the main outcome measures should be conducted.1 A. Faraj, FRCS(Orth&Tr), Consultant Orthopaedic Surgeon, Airedale General Hospital, Department of Orthopaedics, North Yorkshire, UK. 1. Fender D, Harper WM, Thompson JR, Gregg PJ. Mortality and fatal pulmonary embolism after primary total hip replacement: results from a regional hip register. Bone Joint Surg [Br] 1997;79-B:896-9.