PE

Natural History

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%

Prophylaxis

Mechanical prophylaxis

- TEDS

Anatomy

Bony

- 90% load through plafond to talus

- 10% load through lateral talofibular articulation

Ligaments

A.  Lateral Ligament Complex

ATFL (Anterior Talo-Fibular Ligament) 

- tight in plantar flexion