According to the National Institute of Clinical Excellence (NICE) Guidelines, some foot and ankle patients are, by definition, at high risk of DVT/PE. Despite NICE guidance, DVT recommendations are still controversial, and are being reviewed by the BOA to be more operation and context specific.

One consultant at our institution therefore initiated a 6 week medical DVT prophylaxis regimen for all his post-operative hind–foot surgery patients who were placed in plaster. From January 2007 to February 2008 we audited 97 hind-foot patients to measure their compliance rate, complications and DVT/PE rate.

Compliance was excellent (97%) particularly with regard to Low Molecular Weight Heparin (LMWH), but only 70% had medication prescribed for the 6 weeks, and 3% developed a DVT.

Self administered LMWH is acceptable and compliance is excellent in post operative orthopaedic patients, but not necessarily effective.