EFFECTIVENESS OF PNEUMATIC LEG COMPRESSION DEVICES FOR THE PREVENTIONOF THROMBOEMBOLIC DISEASE IN ORTHOPEDIC TRAUMA PATIENTS - A PROSPECTIVE, RANDOMIZED STUDY OF COMPRESSION ALONE VERSUS NO PROPHYLAXIS

A prospective, randomized clinical trial in 304 orthopaedic trauma pat ients with hip and pelvic fractures was conducted to investigate the e ffectiveness of pneumatic sequential leg compression devices (PSLCDs) for the prevention of thromboembolic disease. The control group receiv ed no specific form of prophylaxis. Patients were followed by venous D oppler, duplex scan, and ventilation perfusion lung scans. The study e nd-point was documented pulmonary embolism and/or deep vein thrombosis . The incidence of a venous thromboembolic event in the control group was 11% and in the experimental group 4%. This difference was statisti cally significant (p = 0.02). These patients were also stratified into hip and pelvic fracture groups. In the hip fracture patients, the con trol group had a thromboembolic event incidence of 12% and the experim ental group 4%. This difference was also statistically significant (p = 0.03). In the pelvic fracture group there was a thromboembolic incid ence of 11% in the controls, demonstrating this patient population to be at significant risk. In this group, the PSLCDs were not statistical ly shown to be effective. Pneumatic leg compression devices are effect ive in reducing the incidence of thromboembolic events in patients wit h hip fractures.