Venous thromboembolism following elbow, wrist and hand surgery: a review of the literature and prophylaxis guidelines.

Abstract

This review summarizes the literature regarding venous thromboembolism and examines the prophylaxis guidelines with relation to hand, wrist and elbow surgery. We performed an extensive literature search identifying any relevant case reports or outcome studies. Of 680 potential articles, only four contained data relevant to thrombosis after elbow, wrist and hand surgery. No isolated deep vein thromboses and only nine pulmonary embolisms were identified suggesting that the rate of venous thromboembolism is extremely low following this subset of upper limb surgery. We identified nine guidelines, of which only two (the British Society for Surgery of the Hand and the National Institute of Health and Clinical Excellence) addressed the upper limb. We present a set of recommendations based on the results of this review.