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 the algorithm below in ambulatory, isolated leg injured adult patients with rigid immobilisation (not just removable splint).
- 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