ABSTRACT
Venous thromboembolism (VTE) is a serious medical condition that can be an unfortunate
complication arising from foot and ankle surgery. Many factors may predispose a patient
to a VTE event including prolonged postoperative immobilization, comorbidities, extended
length of tourniquet time, and higher risk surgeries. Unfortunately, there is no clinical
consensus for guidelines on VTE prophylaxis following foot and ankle surgery. In this
retrospective cohort study, we present our patient population who were prophylactically
anticoagulated following foot and ankle surgery along with their incidence of deep
vein thrombosis and pulmonary embolism (PE). Included in the study were patients who
had undergone elective and traumatic foot and ankle surgery from June 2017 to December
2018. Using retrospective data obtained we compared patient demographics, surgery
type, length of tourniquet time, postoperative immobilization, type of VTE prophylaxis,
and comorbidities including history of smoking, peripheral vascular disease, bleeding
disorders, and patients undergoing dialysis. Five of 425 (1.2%) patients were diagnosed
with a deep vein thrombosis and 1 of 425 (0.2%) patients was diagnosed with a pulmonary
embolism. Risks factors statistically significant for developing a VTE in our patient
population included extended periods of immobilization and an increasing patient age.
We were able to conclude that routine prophylaxis for elective and traumatic foot
and ankle surgery is both effective and safe for especially in older patients requiring
extended immobilization. It's also important to take into consideration comorbidities,
smoking history, tourniquet time, and the type of surgery that is being performed.
Level of Clinical Evidence
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Overview of venous thromboembolism.Am J Manag Care. 2017; 23: S376-S382
- Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).Chest. 2008; 133 (Suppl): 381S-453S
- Basic mechanisms and pathogenesis of venous thrombosis.Blood Rev. 2009; 5: 225-229
- Virchow's contribution to the understanding of thrombosis and cellular biology.Clin Med Res. 2010; 8: 168-172
- Venous thromboembolic disease in foot and ankle surgery.JBJS Rev. 2015; 3: 1-8
- Incidence of acute deep vein thrombosis and pulmonary embolism in foot and ankle trauma: analysis of the National Trauma Data Bank.J Foot Ankle Surg. 2012; 51: 63-68
- The incidence of thromboembolic events in surgically treated ankle fracture.J Bone Joint Surg Am. 2012; 94: 502-506
- Meta-analysis and suggested guidelines for prevention of venous thromboembolism (VTE) in foot and ankle surgery.Knee Surg Sports Traumatol Arthrosc. 2016; 24: 1409-1420
- Incidence and risk factors for venous thromboembolism after foot and ankle surgery.Foot Ankle Spec. 2019; 12: 218-227
- Repair of chronic achilles ruptures has a high incidence of venous thromboembolism.Foot Ankle Spec. 2017; 10: 415-420
- Venous thromboembolism and bleeding adverse events in lower leg, ankle, and foot orthopaedic surgery with and without anticoagulants.J Bone Joint Surg Am. 2019; 101: 539-546
- Incidence of acute deep vein thrombosis and pulmonary embolism in foot and ankle trauma: analysis of the National Trauma Data Bank.J Foot Ankle Surg. 2012; 51: 63-68
Article info
Publication history
Published online: March 31, 2022
Footnotes
Financial Disclosures: None reported.
Conflict of Interest: None reported.
Informed consent was obtained for experimentation with human subjects.
Identification
Copyright
© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
