Clinical inquiries. Does anticoagulation prevent thrombosis for persons with fractures distal to the hip?
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).
Brogen
Julie
J
Valley Family Medicine Residency, Renton, WA, USA. Julie_Brogren@valleymed.org
Kelsberg
Gary
G
Safranek
Sarah
S
Nadalo
Dana
D
Janki
Patricia
P
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*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight