VTE prophylaxis for lower-limb immobilisation

Following an acute injury, such as a leg fracture, patients can be discharged home from hospital with leg immobilisation that results in significantly reduced mobility relative to their normal activity. Immobility can increase the risk of developing venous thromboembolism (VTE) (ie deep vein thrombosis [DVT] or pulmonary embolism [PE]), particularly if the patient has other factors increasing their risk (see Risk factors for VTE in nonsurgical patients in hospital). Before discharge, assess the patient for risk of developing VTE and discuss their preference for VTE prophylaxis.

Consider VTE prophylaxis with low molecular weight heparin (LMWH) if prolonged immobility is anticipated or if there are additional patient risk factors; continue until the patient is fully mobile. For dosages, see Low molecular weight heparin for VTE prophylaxis.

For patients admitted to hospital for a procedure to repair a fracture, assess the risk of VTE and manage appropriately; for examples, see VTE prophylaxis for surgical patients in hospital. Similarly, for patients admitted to a medical ward, assess and manage as per the examples in Examples of VTE prophylaxis for nonsurgical patients in hospital.