Incidence of Deep Vein Thrombosis Following Below Knee Casting for Non-Operated Foot and Ankle Injuries

The use of prophylaxis for deep vein thrombosis (DVT) in patients with ankle trauma treated with below knee cast is a controversial issue. The purpose of current study was to investigate the incidence of DVT to look into the necessity of thromboprophylaxis in these patients. Ninty five patients with stable fractures of the foot or ankle or ankle sprains contributed in this cross-sectional study. The level of D-dimer was determined between 7-14 days post-casting. If the level of D-dimer was higher than 0.2 µg/mL the result of the test was considered positive and patient was referred for further examination for DVT using doppler ultrasonography. The role of risk factors in the development of DVT was evaluated. There were 46 patients with at least one DVT risk factor. The D-dimer test was positive in 21 patients (22.1%). Based on the doppler ultrasonography 3 patients developed DVT. There was a statistically significant relation between the presence of multiple risk factors (≥3) and increased risk of DVT development (p=.01). DVT is not a common complication in below knee casting and routine thromboprophylaxis is not necessary in patients with less than 3 risk factors.