SUMMARY
Background: The aim of this systematic review and meta-analysis is to review the effectiveness of low molecular weight heparin (LMWH) and novel oral anticoagulants (NOACs) for thromboprophylaxis in trauma patients treated with lower limb immobilisation.Methods: All randomized controlled trials (RCTs) comparing thromboprophylaxis to no prophylaxis or standard for prevention of venous throboembolism (VTE( in patients with lower limb trauma treated with immobilisation were included.Results: Eight studies totaling 3190 patients were included. The overall incidence of thromboembolic events in the control group ranged from 2.3% to 40% (137/871) and from 0% to 37% (77/884) in the LMWH group (RR 0.57; 95% CI = 0.45 to 0.73), P < 0.00001. One cohort study demonstrated equivalence of NOACs in VTE rate to LMWH with another demonstrating a significant reduction in VTE rates.Conclusions: Our results demonstrate that LWMH is an effective agent in reducing VTE in these patients with an acceptable safety profile.