Background
- Lower limb immobilisation (even transient) significantly increases the risk of VTE
- This is particularly so in those with a predisposition to coagulopathy
- There is no evidence of increased risk in upper limb immobilisation
Management
Approach as per algorithm below in adult patient with isolated traumatic limb injury suitable for ambulatory outpatient care. Any immobilisation proposed (to include splint, non-weight bearing or any form of plaster cast).
- No strong evidence to support oral anticoagulation but consider using off licence
- When indicated, LMWH is effective in preventing VTE
- If started, continue LMWH / DOAC until PoP is removed