DVT

DVT PE

Natural History

 

Insall 1984 / no prophylaxis

- DVT 70 - 80%

- asymptomatic PE  8 -17%

- symptomatic PE  0.5 -3%

- death  0.2%

- most commonly in calf / 85-90% below trifurcation

 

THR

- THR only 10-15% below trifurcation

 

Bilateral DVT in 10-15%

 

Prophylaxis

 

Mechanical prophylaxis

- TEDS

DVT / PE

 

ANZ Working Party on the Management and Prevention of Venous Thromboembolism 2007

 

Note

 

Top 6 conditions associated with DVT

- stroke

- THR

- multi trauma

- TKR

- hip fracture

- spinal cord injury

 

Not one of the 12 doctors was an orthopaedic surgeon

 

Agents

 

Heparin / LMWH / fondaparinux

- confirmed effectiveness