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Update der Thromboseprophylaxe in Orthopädie und Unfallchirurgie

An update on thrombosis prophylaxis in orthopaedic and accident surgery

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Zusammenfassung

Eine routinemäßige Thromboseprophylaxe ist fester Bestandteil der orthopädisch-chirurgischen Behandlung. Trotz unbestrittener Notwendigkeit der Prophylaxe bestehen bei der praktischen Durchführung oft noch Unklarheiten. Die Entwicklung neuer Medikamente in den letzten Jahren vergrößert die Bandbreite der Prophylaxeprinzipien und schafft neuen Informationsbedarf. In der folgenden Übersicht werden die Indikationen in Abhängigkeit vom expositionellen und dispositionellen Risiko des Patienten dargestellt. Es wird ein Überblick über die aktuellen Prophylaxemethoden, ihre pharmakologischen Details und klinische Relevanz gegeben. Vor dem Hintergrund evidenzbasierter Daten und der Empfehlungen der Fachgesellschaften wird zur Dauer der Prophylaxe, zur Kosten-Nutzen-Relation und zu forensischen Fragen Stellung bezogen.

Abstract

The prevention of deep venous thrombosis has become a routine in orthopaedic surgery. While the necessity for prophylaxis is not questioned, its practice is still a matter of controversy. The development of new anticoagulants increases the variety of prophylactic methods but leads to a need for additional information. This review deals with the indications for thrombosis prophylaxis in relation to exposing and predisposing risk factors. The currently available modalities of prophylaxis, their pharmacological details and clinical significance are presented. Evidence based data, recommendations on the duration of prophylaxis derived from official guidelines, issues of the cost/effectiveness, and medico-judicial aspects are discussed.

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Authors and Affiliations

  1. Orthopädische Klinik der Universität Regensburg im Bayerischen Rheuma- und Orthopädiezentrum, Bad Abbach

    J. Grifka

  2. , München

    S. Haas

  3. Städt. Krankenhaus Ffm.-Höchst, Orthopädische Klinik, Frankfurt/Main

    L. Hovy

  4. Universitätsklinik des Saarlandes, Homburg Saar

    W. Knopp

  5. Klinik u. Poliklinik der Ludwigs-Maximilian-Universität, München

    H. L. Refior

  6. Unfallchirurgie, Klinikum Hof

    M. Schürmann

  7. Klinik für Orthopädie, Klinikum der Philipps-Universität, Marburg

    T. Wirth

  8. Orthopädische Klinik der Universität Regensburg im Bayerischen Rheuma- und Orthopädiezentrum, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach

    J. Grifka

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  1. J. Grifka
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  2. S. Haas
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  3. L. Hovy
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  4. W. Knopp
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  6. M. Schürmann
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  7. T. Wirth
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Correspondence to J. Grifka.

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Die Autoren sind Mitglieder des OTIC-Advisory Boards, AstraZeneca

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Grifka, J., Haas, S., Hovy, L. et al. Update der Thromboseprophylaxe in Orthopädie und Unfallchirurgie. Orthopäde 33, 762–773 (2004). https://doi.org/10.1007/s00132-004-0671-y

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  • DOI: https://doi.org/10.1007/s00132-004-0671-y

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