PMID: 7939738Jul 1, 1994Paper

Is prevention of thromboembolism in ambulatory and conservative therapy of rupture of the fibular ligament of the upper ankle joint necessary?

Der Unfallchirurg
H GehlingJ Henkel


In a prospective clinical study, 111 outpatients with tears of the lateral ankle ligaments were investigated for the occurrence of deep venous thrombosis (DVT). All patients had been treated by a plaster cast for 1 week and had not received any form of DVT prophylaxis. After removal of the plaster cast (mean 7.1 days), colour flow imaging of the veins of the injured leg was performed. A phlebography was undertaken whenever there was any suspicion of DVT. Risk factors for thrombosis [3, 10] were documented in all patients. Besides injury and immobilisation, a median of 1.2 (0-4) risk factors for DVT was involved. Only 31 patients had no additional risk factors at all. Median age of the patients was 26.1 years (16-53 median range). Only 1 patient over 40 years of age was diagnosed as having DVT, and none under 40. Therefore, medicamentous prophylaxis of DVT is not considered necessary in outpatients younger than 40 years with ankle ligament tears treated by bi-valved casts in cases when there are no additional risk factors (Table 4) for DVT.

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