Abstract: Significant patient morbidity and mortality is associated with the development of venous thromboembolism (VTE) following orthopedic surgery. The majority of the literature supports proper prophylaxis following major orthopedic surgery involving hip and knee procedures. Foot and ankle surgery, however, is starkly contrasted because of the lack of recommendations. This article provides a comprehensive overview of the risk factors and incidence of VTE in foot and ankle surgery while also outlining the newest literature guidelines for prophylaxis.
MuntzJ. Thromboprophylaxis in orthopedic surgery: how long is long enough?Am J Orthop. 2009;38:394-401.
2.
SchadeVLRoukisTS. Antithrombotic pharmacologic prophylaxis use during conservative and surgical management of foot and ankle disorders: a systematic review. Clin Podiatr Med Surg. 2011;28:571-588.
3.
GeertsWHBergqvistDPineoGF. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest. 2008;133:381S-453S.
4.
VirchowR. Neuer fall von todlicher. Embolie der lungenarterien. Arch Pathol Anat. 1856;10:225.
5.
MayleREJrDiGiovanniCWLinSS. Current concepts review: venous thromboembolic disease in foot and ankle surgery. Foot Ankle Int. 2007;28:1207-1216.
6.
SlaybaughRSBeasleyBDMassaEG. Deep venous thrombosis risk assessment, incidence, and prophylaxis in foot and ankle surgery. Clin Podiatr Med Surg. 2003;20:269-289.
7.
PetersonKSMendicinoRWCatanzaritiARSaltrickKS. Deep vein thrombosis after bunionectomy: a case report of two genetic mutations. J Foot Ankle Surg. 2011;50:733-735.
8.
HardyMA. Thromboembolic prophylaxis in foot and ankle surgery: what should we do?Foot Ankle Spec. 2011;4:120-123.
9.
CapriniJA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51:70-78.
10.
KennedyDSetnikGLiJ. Physical examination findings in deep venous thrombosis. Emerg Med Clin North Am. 2001;19:869-876.
11.
KearonCJulianJAMathM. Noninvasive diagnosis of deep venous thrombosis. Ann Intern Med. 1998;128:663-667.
12.
DeitcherSRCapriniJA. Calf deep venous thrombosis should be treated with anticoagulation. Med Clin North Am. 2003;87:1157-1164.
13.
KahnSPartschHVedanthamS; on behalf of the Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization. J Thromb Haemost. 2009;7:879-883.
14.
BaglinT. What happens after venous thromboembolism. J Thromb Haemost. 2009;7(suppl 1):287-290.
15.
LaporteSMismettiPDecoususH. Clinical predictors for fatal pulmonary embolism in 15 520 patients venous thromboembolism: findings from the Registro Informatizado de la Enfermedad Tromboembolica venosa (RIETE) Registry. Circulation. 2008;117:1711-1716.
16.
KearonC. Natural history of venous thromboembolism. Circulation. 2003;107:122-130.
17.
MizelMSTempleHTMichelsonJD. Thromboembolism after foot and ankle surgery: a multicenter study. Clin Orthop Relat Res. 1998;348:180-185.
18.
SolisGSaxbyT. Incidence of DVT following surgery of the foot and ankle. Foot Ankle Int. 2002;23:411-414.
19.
HanslowSSGrujicLSlaterHKChenD. Thromboembolic disease after foot and ankle surgery. Foot Ankle Int. 2006;27:693-695.
20.
WukichDKWatersDH. Thromboembolism following foot and ankle surgery: a case series and literature review. J Foot Ankle Surg. 2008;47:243-249.
21.
FelcherAHMularskiRAMosenDM. Incidence and risk factors for venous thromboembolic disease in podiatric surgery. Chest. 2009;135:917-922.
22.
RadlRKastnerNAignerC. Venous thrombosis after hallux valgus surgery. J Bone Joint Surg. 2003;85-A:1204-1208.
23.
PatelAOgawaBCharltonTThordarsonD. Incidence of deep vein thrombosis and pulmonary embolism after Achilles tendon rupture. Clin Orthop Rel Res. 2012;470:270-274.
24.
SooHooNFFarngEZingmondDS. Incidence of pulmonary embolism following surgical treatment of metatarsal fractures. Foot Ankle Int. 2010;31:600-603.
25.
ShibuyaNFrostCHCampbellJD. 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.
26.
JamesonSSAugustineAJamesP. Venous thromboembolic events following foot and ankle surgery in the English National Health Service. J Bone Joint Surg. 2011;93-B:490-497.
27.
LapidusLJPonzerSElvinA. Prolonged thromboprophylaxis with Dalteparin during immobilization after ankle fracture surgery: a randomized placebo-controlled, double-blind study. Acta Orthop. 2007;78:528-535.
28.
LapidusLJRosfersSPonzerS. Prolonged thromboprophylaxis with Dalteparin after surgical treatment of Achilles tendon rupture: a randomized, placebo-controlled study. J Orthop Trauma. 2007;21:52-57.
29.
PeletSRogerMEBelzileEL. The incidence of thromboembolic events in surgically treated ankle fracture. J Bone Joint Surg. 2012;94-A:502-506.
30.
Falck-YtterYFrancisCWJohansonNA. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 suppl):e278S-e325S.
31.
TurpieAGBauerKAErikssonBI. Postoperative fondaparinux versus postoperative enoxaparin for prevention of venous thromboembolism after elective hip replacement surgery: a randomised double-blind trial. Lancet. 2002;359:1721-1726.
32.
LotkePALonnerJH. The benefit of aspirin chemoprophylaxis for thromboembolism after total knee arthroplasty. Clin Orthop Relat Res. 2006;452:175-180.
33.
Pulmonary Embolism Prevention (PEP) Trial Collaborative Group. Prevention of pulmonary embolism and deep vein thrombosis with low-dose aspirin. Lancet. 2000;355:1295-1302.
34.
LeonardiMJMcGoryMLKoCY. The rate of bleeding complications after pharmacologic deep venous thrombosis prophylaxis: a systematic review of 33 randomized controlled trials. Arch Surg. 2006;141:790-799.
35.
AmstutzHCFrisciaDADoreyF. Warfarin prophylaxis to prevent mortality from pulmonary embolism after total hip replacement. J Bone Joint Surg. 1989;71-A:321-326.
36.
LotkePACallaghanJJDorrLD. Prophylaxis for thromboembolic disease. J Arthroplasty. 2005;20:273-274.
37.
PaiementGDWessingerSJHughesR. Routine use of adjusted low dose warfarin to prevent venous thromboembolism after total hip replacement. J Bone Joint Surg. 1993;75-A:893-898.
38.
DiGiovanniCW. Current concepts review: heparin-induced thrombocytopenia. Foot Ankle Int. 2008;29:1158-1167.
39.
GirolamiBGirolamiA. Heparin-induced thrombocytopenia: a review. Semin Thromb Hemost. 2006;32:803-809.
