Skip to main content

Advertisement

Log in

Role of calf muscle stimulation in the prevention of DVT in Indian patients undergoing surgeries for fractures around the hip

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

The venous stasis of soleal vein during surgery may be an important factor in the development of deep vein thrombosis (DVT). The stimulation of calf muscle during surgery may help in preventing DVT. The present study is conducted to evaluate the role of peroperative calf muscle electrostimulation in prevention of DVT in patients undergoing surgeries around the hip joint.

Materials and Methods

The study comprised 200 patients undergoing surgeries around the hip joint. The patients having risk factors (such as previous myocardial infarction, malignancies, paraplegia or lower limb monoplegia, previous history of DVT or varicose veins, etc.) for the development of DVT were excluded. They were randomized into two groups: 100 cases were given peroperative calf muscle electrostimulation for DVT prophylaxis (Group A) and the remaining 100 patients were taken as controls without any prophylaxis (Group B). The color Doppler ultrasound was performed to exclude pre-existing DVT and on 7th day postoperative to find out the incidence of DVT in both the groups.

Results

Two patients among Group A and six patients among Group B demonstrated DVT on ultrasonography, but the difference was not found to be statistically significant (P=0.279). None of the patients had any clinical evidence of DVT.

Conclusion

The role of peroperative calf muscle electrostimulation for DVT prophylaxis remains controversial. The risk of developing DVT in patients undergoing surgeries around the hip joint is very less in patients analysed in our series.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cronan JJ, Dorfman GS, Grusmark J. Lower-extremity deep venous thrombosis: further experience with and refinements of US assessment. Radiology 1988;168:101–7.

    Article  CAS  Google Scholar 

  2. Stulberg BN, Insall JN, Williams GW, Ghelman B. Deepvein thrombosis following total knee replacement. An analysis of six hundred and thirty eight arthroplasties. J Bone Joint Surg Am 1984;66:194–201.

    Article  CAS  Google Scholar 

  3. Dhillon KS, Askander A, Doraisamy S. Postoperative deepvein thrombosis in Asian patients is not a rarity: A prospective study of 88 patients with no prophylaxis. J Bone Joint Surg Br 1996;78:427–30.

    Article  CAS  Google Scholar 

  4. Agarwala S, Bhagwat AS, Modhe J. Deep vein thrombosis in Indian patients undergoing major lower limb surgery. Indian J Surg 2003;65:159–62.

    Google Scholar 

  5. Doran FS, Drury M, Sivyer A. A simple way to combat the venous stasis which occurs in the lower limbs during surgical operations. Br J Surg 1964;51:486–92.

    Article  CAS  Google Scholar 

  6. Lindstrom B, Holmdahl C, Jonsson O, Korsan-Bengtsen K, Lindberg S, Petruson B, et al. Prediction and prophylaxis of postoperative thromboembolism- a comparison between peroperative calf muscle stimulation with groups of impulses and dextran 40. Br J Surg 1982;69:633–7.

    Article  CAS  Google Scholar 

  7. Zuccarelli F, Launay J, Le Magrex J, Mollard R, Fargier P, Pujo M. Activation of the calf muscle pump action by electro-stimulation with VenioPlusdevice. J Angeiologie 2005;57:1–7.

    Article  Google Scholar 

  8. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008;133(Suppl 6):S381–453.

    Article  Google Scholar 

  9. White RH, Keenan CR. Effects of race and ethnicity on the incidence of venous thromboembolism. Thromb Res 2009;123(Supp14):S11–7.

    Article  CAS  Google Scholar 

  10. Jain V, Dhal AK, Dhaon BK, Pradhan G. Deep vein thrombosis after total hip arthroplasty in Indian patients with and without enoxaparin. J Orth Surg 2004;12:173–7.

    Article  CAS  Google Scholar 

  11. Bagaria V, Modi N, Panghate A, Vaidya S. Incidence and risk factors for development of venous thromboembolism in Indian patients undergoing major orthopaedic surgery: results of a prospective study. Postgrad Med J 2006;82:136–9.

    Article  CAS  Google Scholar 

  12. Mavalankar AP, Majmundar D, Shubha R. Routine chemoprophylaxis for deep venous thrombosis in Indian patients: is it really justified? Indian J Orthop 2007;41:188–93.

    Article  Google Scholar 

  13. Kim YH, Oh SH, Kim JS. Incidence and natural history of deepvein thrombosis after total hip arthroplasty: a prospective and randomised clinical study. J Bone Joint Surg Br 2003;85:661–5.

    Article  Google Scholar 

  14. Gottlieb RH, Widjaja J, Tian L, Rubens DJ, Voci SL. Calf sonography for detecting deep venous thrombosis in symptomatic patients: experience and review of literature. J Clin Ultrasound 1999;27:415–20.

    Article  CAS  Google Scholar 

  15. Bjorgell O, Nilsson PE, Jarenros H, Bjorgell O. Isolated nonfiling of contrast in deep leg vein segments seen on phlebography, and a comparison with colour Doppler ultrasound, to assess the incidence of deep leg vein thrombosis. Angiology 2000;51:451–61.

    Article  CAS  Google Scholar 

  16. Colwell CW Jr, Froimson MI, Mont MA, Ritter MA, Trousdale RT, Buehler KC, et al. Thrombosis prevention after total hip arthroplasty: a prospective, randomized trial comparing a mobile compression device with low-molecular-weight heparin. J Bone Joint Surg Am 2010;92:527–35.

    Article  Google Scholar 

  17. Froehlich JA, Dorfman GS, Cronan JJ, Urbanek PJ, Herndon JH, Aaron RK. Compression ultrasonography for the detection of deep venous thrombosis in patients who have a fracture of the hip. A prospective study. J Bone Joint Surg Am 1989;71:249–56.

    Article  CAS  Google Scholar 

  18. Piovella F, Wang CJ, Lu H, Lee K, Lee LH, Lee WC, et al. Deep-vein thrombosis rates after major orthopaedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography. J Thromb Hemostat 2005;3:2664–70.

    Article  CAS  Google Scholar 

  19. Atichartakarn V, Pathpchotiwong K, Keorochana S, Eurvilaichit C. Deep vein thrombosis after hip surgery among Thai. Arch Intern Med 1988;148:1349–53.

    Article  CAS  Google Scholar 

  20. Mitra AK, Khoo TK, Ngan CC. Deep-vein thrombosis following hip surgery for fracture of the proximal femur. Singapore Med J 1989;30:530–4.

    CAS  PubMed  Google Scholar 

  21. Binns M, Pho R. Femoral vein occlusion during hip arthroplasty. Clin Orthop Relat Res 1990;255:168–72.

    Google Scholar 

  22. Sculco TP, Bottner F. Current concepts of nonpharmacologic thromboembolic prophylaxis. Instr Course Lect 2002;51:481–6.

    PubMed  Google Scholar 

  23. Di Giovanni CW, Restrepo A, Delia Valle AG, Sharrock NE, McCabe JP, Sculco TP, et al. The safety and efficacy of intraoperative heparin in total hip arthroplasty. Clin Orthop Relat Res 2000;379:178–85.

    Article  Google Scholar 

  24. Comerota AJ, Katz ML, White JV. Why does prophylaxis with external pneumatic compression for deep vein thrombosis fail? Am J Surg 1992;164:265–8.

    Article  CAS  Google Scholar 

  25. Ryan MG, Westrich GH, Potter HG, Sharrock N, Maun LM, Macaulay W, et al. Effect of mechanical compression on the prevalence of proximal deep venous thrombosis as assessed by magnetic resonance venography. J Bone Joint Surg Am 2002;84:1998–2004.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aman Goyal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Goyal, A., Arora, S., Batra, S. et al. Role of calf muscle stimulation in the prevention of DVT in Indian patients undergoing surgeries for fractures around the hip. IJOO 46, 542–547 (2012). https://doi.org/10.4103/0019-5413.101034

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/0019-5413.101034

Key words

Navigation