Fractures of the lower extremities

Summary

Evidence from one randomized controlled trial suggests that for hip fracture patients, short-term heparin-type prophylaxis with an extended duration of 4 – 6 weeks for prevention of venous thromboembolitic events leads to significantly lower venous thromboembolism (VTE) than in those given a placebo following a short-term prophylaxis. In patients with ankle fractures, VTE was less frequent for short-term plus extended prophylaxis versus the short-term plus placebo, but differences were not statistically significant. Overall mortality rates were not significantly affected by prophylaxis status in either study, but extended treatment with fondaparinux following the short-term course after hip fractures resulted in slightly higher rates of major bleeding compared with those receiving the short-term course followed by placebo. Additional trials are needed to confirm these results.