Table A7

Risks of thromboprophylaxis

Testroote M et al, 2008, NetherlandsPatients with lower limb injuries managed as outpatients in lower limb plaster casts or bracesSix studies included (1490 patients), of which four studies included patients treated non-surgically (788 patients). 750 patients were given thromboprophylaxis with LMWH (level of evidence 1a)Incidence of major bleedingLMWH group: two patients (0.26%), Control group: one patient (0.14%)Statistical and clinical heterogeneity. The numbers of patients included in the studies are small. The assessment of safety includes patients managed surgically. One of the studies included uses as a subprophylactic dose of LMWH
Incidence of minor bleedingLMWH group: 14 patients (1.87%), Control group: 12 patients (1.62%)
Otero-Fernandez R et al, 2008, Spain (157 centres)Orthopaedic patients requiring outpatient thromboprophylaxis with Bemiparin. Included 6456 patients, of which 1789 patients were managed conservatively with cast immobilisationProspective uncontrolled multicentre cohort (level of evidence 2b)Incidence of major bleedingOverall: 0.17%, Plaster cast group: 0.11%No control group. Two different doses of Bemiparin used (2500 IU and 3500 IU) selected at clinicians’ discretion
Incidence of minor bleedingOverall: 4.57%, Plaster cast group: 1.51%
Incidence of thrombocytopeniaOverall: 0.51%, Plaster cast group: 0.17%
  • LMWH, low molecular weight heparin.