UK national survey of venous thromboembolism prophylaxis in ankle fracture patients treated with plaster casts

BackgroundAnkle fractures are one of the commonest orthopaedic injuries. A substantial proportion of these are treated non-operatively at outpatient clinics with cast immobilization. We conducted this survey to assess the current practice in UK regarding thromboembolism prophylaxis in these patients.MethodsA telephonic survey was carried out on junior doctors within orthopaedic departments of 56 hospitals across the UK. A questionnaire was completed regarding venous thromboembolism risk assessment, prophylaxis, hospital guidelines, etc.Results84% (n = 47) hospitals did not routinely use any prophylaxis for these patients, while 7% (n = 4) hospitals used chemo-prophylaxis. Only 5.3% (n = 3) hospitals had DVT prophylaxis guidelines regarding these patients while other 9% (n = 5) hospitals were in process of developing such guidelines. In 64% (n = 36) hospitals, no formal DVT risk assessment was carried out.ConclusionA large variation exists across NHS hospitals and a poor risk assessment is being carried out in these patients. Development of local guidelines and extension of national guidelines to include high risk outpatients may improve the situation.