title: Clinical inquiries. Does anticoagulation prevent thrombosis for persons with fractures distal to the hip?
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).
authors.affiliation: Valley Family Medicine Residency, Renton, WA, USA. Julie_Brogren@valleymed.org
authors.forename: Julie
authors.initials: J
authors.lastname: Brogen
authors.forename: Gary
authors.initials: G
authors.lastname: Kelsberg
authors.forename: Sarah
authors.initials: S
authors.lastname: Safranek
authors.forename: Dana
authors.initials: D
authors.lastname: Nadalo
authors.forename: Patricia
authors.initials: P
authors.lastname: Janki
mesh_terms: D000367:Age Factors; D000925:Anticoagulants / Q000627:therapeutic use*; D050723:Fractures, Bone / Q000150:complications* / Q000628:therapy; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007869:Leg Injuries / Q000150:complications* / Q000628:therapy; D020246:Venous Thrombosis / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight