ReviewThromboembolism Following Foot and Ankle Surgery: A Case Series and Literature Review
Section snippets
Patients and Methods
Formal approval of this retrospective study and a waiver of HIPAA authorization to access protected health information was granted by our university's institutional review board before initiation of this study. Patient medical record information over a 1.5-year period, from January 2005 to June 2006, was retrospectively reviewed and evaluated. The inclusion group was a consecutive series of 1000 patients who underwent foot and ankle surgery by one surgeon over a 1.5-year period. None of the
Results
The principal investigator (D.W.) performed foot and ankle surgery on 1000 consecutive patients over the course of 1.5 years. Descriptive results for the case series are depicted in Table 1. No patients undergoing outpatient surgery received prophylaxis against VTE. All patients undergoing surgery that required admission to the hospital received low molecular weight heparin (Lovenox 40 mg) subcutaneously beginning on the morning following surgery. They remained on this during their hospital
Risk Factors
Numerous risk factors of surgery, especially orthopedic procedures, have been linked to increased rates of thromboembolism. Inherited or acquired hypercoagulable states are reported to exist in 20% to 30% of DVT cases (6, 7). The most common of the inherited hypercoagulable states is Factor V Leiden, a mutated form of coagulation factor V (2, 3, 6, 8). Factor V Leiden causes resistance to protein C antithrombotic activity (2, 3, 6, 8). Prothrombin G20210A mutation, anticardiolipin antibody
References (15)
- et al.
Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy
Chest
(2004) - et al.
Deep venous thrombosis risk assessment, incidence, and prophylaxis in foot and ankle surgery
Clin Podiatr Med Surg
(2003) - et al.
Update in pulmonary medicine
Clin Podiatr Med Surg
(2002) - et al.
Low-molecular-weight heparin for deep vein thrombosis prophylaxis in foot and ankle surgery: a review
J Foot Ankle Surg
(2001) - et al.
Pulmonary embolism following operative treatment of ankle fractures: a report of 3 cases and review of the literature
Foot Ankle Int
(2002) - et al.
Thromboembolism after foot and ankle surgery: a multicenter study
Clin Orthop Relat Res
(1998) - et al.
Thromboembolic disease after foot and ankle surgery
Foot Ankle Int
(2006)
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Conflict of Interest: None reported.