Insall 1984 / no prophylaxis
- DVT 70 - 80%
- asymptomatic PE 8 -17%
- symptomatic PE 0.5 -3%
- death 0.2%
- most commonly in calf / 85-90% below trifurcation
THR
- THR only 10-15% below trifurcation
Bilateral DVT in 10-15%
Mechanical prophylaxis
- TEDS
Top 6 conditions associated with DVT
- stroke
- THR
- multi trauma
- TKR
- hip fracture
- spinal cord injury
Not one of the 12 doctors was an orthopaedic surgeon
Heparin / LMWH / fondaparinux
- confirmed effectiveness
- 90% load through plafond to talus
- 10% load through lateral talofibular articulation
A. Lateral Ligament Complex
ATFL (Anterior Talo-Fibular Ligament)
- tight in plantar flexion