Venous thromboembolism following prolonged cast immobilisation for injury to the tendo Achillis
Venous thromboembolism following prolonged cast immobilisation for injury to the tendo Achillis
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DOI：
10.1302/0301-620x.92b5.23241
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发表时间：
2010-05-01
影响因子：
--
通讯作者：
Weatherall, M.
中科院分区：
文献类型：
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作者：
Healy, B.;Beasley, R.;Weatherall, M.
我们报告了2006年1月至2007年12月期间在惠灵顿医院骨科评估部门就诊的208例平均年龄为39岁（16至65岁）的患者，他们的跟腱受伤需要用石膏固定。所有患者的静脉血栓栓塞（VTE）风险评估、预防措施和VTE事件信息均来自医疗记录。在3例（1%）患者的记录中记录了静脉血栓栓塞的危险因素。208例患者中有1例接受阿司匹林预防治疗；没有人接受低分子量肝素治疗。总共有13例患者（6.3%，95%可信区间3.4 - 10.5）在固定石膏期间出现症状性静脉血栓形成，包括6例远端深静脉血栓形成（DVT）， 4例近端深静脉血栓形成，3例确诊肺栓塞。这种症状性静脉血栓栓塞的发生率与选择性髋关节置换术后报道的发生率相似。我们建议在长时间固定下肢时考虑静脉血栓栓塞预防，以确保提供与选择性髋关节置换术患者相同水平的保护。
We report an audit of 208 patients with a mean age of 39 years (16 to 65) attending the Orthopaedic Assessment Unit at the Wellington Hospital between January 2006 and December 2007 with an injury of the tendo Achillis requiring immobilisation in a cast. Information on assessment of venous thromboembolism (VTE) risk, prophylactic measures and VTE events for all patients was obtained from the medical records. A VTE risk factor was documented in the records of three (1%) patients. One of the 208 patients received aspirin prophylaxis; none received low molecular weight heparin. In all, 13 patients (6.3%, 95% confidence interval 3.4 to 10.5) developed symptomatic VTE during immobilisation in a cast, including six with a distal deep-vein thrombosis (DVT), four with a proximal DVT, and three with a confirmed pulmonary embolus. This incidence of symptomatic VTE is similar to that reported following elective hip replacement.We propose that consideration is given to VTE prophylaxis during prolonged immobilisation of the lower limbs in a cast, to ensure that the same level of protection is provided as for patients undergoing elective hip replacement.