title: Deep vein thrombosis following below knee immobilization: the need for chemoprophylaxis.
abstract: BACKGROUND
  There is controversy regarding routine prophylaxis for deep vein thrombosis (DVT) in patients treated via a short leg cast or splint following lower extremity trauma.
  
  
  OBJECTIVE
  The main aim of this study is to evaluate the incidence of DVT and need for chemoprophylaxis in these patients.
  
  
  METHODS
  Patients with ankle sprains or stable foot/ankle fractures were entered in this cross-sectional study. Serum D-dimer levels were measured 2 weeks following fixation. If the D-dimer levels were above 0.2 micrograms/ml the test was considered positive and the patient was referred for Doppler ultrasound examination (DUE) to confirm or rule out the diagnosis of DVT. Finally, the incidence of DVT was calculated and the role of predisposing factors was investigated.
  
  
  RESULTS
  There were 95 patients with an average age of 38 ± 13.7 (77.9% males); 46 patients had at least one risk factor for DVT. The D-dimer test was positive in 21(22.1%) patients. DVT was confirmed by DUE in 3 patients (3.1%). The incidence of DVT significantly increased in the presence of 3 or more risk factors (P = 0.01).
  
  
  CONCLUSIONS
  It seems that DVT is not a common complication of below knee fixation and chemoprophylaxis is not necessary when the patient has less than 3 predisposing factors. With 3 or more risk factors chemoprophylaxis and periodic follow-ups must be considered.
authors.affiliation: Department of Orthopedic and Trauma Surgery, Shahid Beheshti University of Medical Sciences, Imam Hossein Hospital, Tehran, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Manafi Rasi
authors.affiliation: Department of Orthopedic and Trauma Surgery, Shahid Beheshti University of Medical Sciences, Imam Hossein Hospital, Tehran, IR Iran.
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Kazemian
authors.affiliation: Department of Orthopedic and Trauma Surgery, Shahid Beheshti University of Medical Sciences, Imam Hossein Hospital, Tehran, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Emami Moghadam
authors.affiliation: Department of Orthopedic and Trauma Surgery, Shahid Beheshti University of Medical Sciences, Imam Hossein Hospital, Tehran, IR Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Tavakoli Larestani
authors.affiliation: Department of Orthopedic and Trauma Surgery, Shahid Beheshti University of Medical Sciences, Imam Hossein Hospital, Tehran, IR Iran.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Fallahi
authors.affiliation: Department of Orthopedic and Trauma Surgery, Shahid Beheshti University of Medical Sciences, Imam Hossein Hospital, Tehran, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Nemati
authors.affiliation: Department of Physical Medicine and Rehabilitation, Tehran University of Medical Sciences, Firuzgar Hospital, Tehran, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Nazari
authors.affiliation: Kashan Nursing and Midwifery College, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Fateme
authors.initials: F
authors.lastname: Fallahi
authors.affiliation: Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Imam Hossein Hospital, Tehran, IR Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Safari
keywords: Immobilization; Knee Joint; Prophylaxis; Venous Thrombosis