Venous thromboembolism during hip plaster cast immobilisation: review of the literature.
BACKGROUND
There is a paucity of data regarding the risk of deep vein thrombosis during hip plaster cast immobilisation. The purpose of this article was to review the available evidence regarding the incidence of symptomatic venous thromboembolism (VTE) during hip plaster cast immobilisation.


METHODS
All papers describing hip plaster cast immobilisation published in the English literature retrieved from PubMed, EMBASE and the Cochrane database were reviewed. Articles regarding children, hip dysplasia, congenital hip dislocation and Legg-Calvé-Perthes were excluded. A total of three papers were available for analysis. We also describe a case of pulmonary embolism during hip cast immobilisation.


RESULTS
The overall incidence of symptomatic VTE during hip plaster cast immobilisation was 0% in 343 patients. The incidence of symptomatic VTE in hip cast brace was 2.3% (range 0-3%).


CONCLUSIONS
Our systematic review of the literature showed a paucity of data regarding the incidence of VTE during hip plaster cast immobilisation. We describe the first case of pulmonary embolism during hip plaster cast immobilisation. We recommend that patients who are fitted with a hip plaster cast should be routinely screened for additional risk factors. When risk factors are present, patients should be considered for pharmacological thromboprophylaxis.
Department of Orthopaedic Surgery and Traumatology, Isala Clinics, Zwolle, the Netherlands.
M C
MC
Struijk-Mulder
H B
HB
Ettema
R A J
RA
Heyne
J J
JJ
Rondhuis
H R
HR
Büller
C C P M
CC
Verheyen
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D002370:Casts, Surgical / Q000009:adverse effects / Q000706:statistics & numerical data*; D004334:Drug Administration Schedule; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007103:Immobilization / Q000009:adverse effects* / Q000706:statistics & numerical data; D008161:Lumbosacral Region; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011859:Radiography; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight