Evidence for treatment of muscular vein thrombosis in orthopaedic patients

Journal of Orthopaedics and Traumatology

William Nash¹  Ioannis Pengas¹  Natasha Reed²  Sunil Kumar² 

[1] Princess Alexandra Hospital$$;Queens Hospital$$

关键词: Isolated gastrocnemius or soleus calf vein thrombosis;   

DOI  :  10.1007/s10195-013-0241-3

学科分类：骨科学

来源: Springer

【 摘 要 】

Background

Does below-knee symptomatic muscular (gastrocnemius or soleus) vein thrombosis (MVT) warrant investigation and treatment in post-operative orthopaedic patients? We performed a literature search and evaluated the evidence looking for guidance regarding this question.

Materials and methods

We performed a literature search with the use of PubMed, Medline and Google Scholar from 1950 to September 2011. Search terms included “muscular vein thrombosis” (MVT) and “isolated gastrocnemius or soleus vein thrombosis” (IGSVT). We reviewed the eight level II studies relevant to our search, only one of which was in a specific orthopaedic population.

Results

Studies looking at the rates of progression of isolated MVT have shown conflicting results. There is also a lack of consensus between studies that compare progression amongst groups with or without anticoagulant treatment. The majority of the studies do not distinguish between medical, surgical or orthopaedic patients.

Conclusions

We cannot confidently recommend commencement of anticoagulation treatment upon identification of MVT in post-operative orthopaedic patients. We can only suggest that, once MVT is diagnosed, the patient should undergo serial ultrasound scan (USS) duplex scans, and if propagation is identified, then treatment may be deemed beneficial.

Level of evidence: III (review of non-randomized controlled cohort/follow-up studies).

【 授权许可】

Unknown