Prevalence of Deep Vein Thrombosis in Low-Risk Patients After Elective Foot and Ankle Surgery

Abstract

Background: The evidence regarding the prevalence of deep vein thrombosis (DVT) after foot and ankle surgery in elective patients that need to be 6 weeks non–weight bearing postoperatively is incomplete and has limitations. Methods: The prevalence of DVT in 114 procedures involving the hindfoot and midfoot was determined using ultrasonographic surveillance at 2 and 6 weeks after surgery. Results: The prevalence of DVT was observed to be 25.4%. The majority (68.9%) of DVTs were diagnosed at the ultrasonographic scan performed 2 weeks postoperatively. The remainder (31.1%) of DVTs were diagnosed at the 6-week postoperative ultrasonographic scan. At least 75% of the patients who had early and late DVT had no clinical symptoms or signs of DVT. The prevalence of DVT in clinically detectable patients was 6%. The average age of patients with early DVT was 62.2 years, significantly higher compared to those who had no DVT. The mean tourniquet time for patients with early DVT was 68.1 minutes, significantly higher compared to those without DVT. All DVTs detected were distal to the popliteal vein. Conclusions: The prevalence of clinically silent DVT was significantly higher than was previously thought. We believe this increased rate is directly attributable to the use of ultrasonographic surveillance postsurgery both at 2 and 6 weeks. The risk of DVT continued after the 2-week visit, and 30% of the DVTs were detected at the ultrasonographic scan at 6 weeks. Level of Evidence: Level II, prospective cohort.

The Application of an Allogenic Bone Screw for Stabilization of a Modified Chevron Osteotomy: A Prospective Analysis

“…In other operations, the higher stiffness of metal screws is beneficial for earlier weightbearing. This reduces postoperative thromboembolic events and reduces the duration of the patient’s sick leave [ 26 , 27 , 28 ].…”

Incidence and Hematological Biomarkers Associated With Preoperative Deep Venous Thrombosis Following Foot Fractures

“…The incidence of DVT following foot and ankle surgeries has been reported to be from 0.22% to 25.4%. 20,27 However, there were various heterogeneities in study populations, research design, and risk factors in previous studies. Therefore, we expected an accurate incidence and reliable risk factors independently associated with DVT in patients following closed foot fracture.…”

“…Deep venous thrombosis (DVT) of the lower extremities is a common complication in patients with trauma. The incidence of DVT following foot and ankle surgeries was reported to vary greatly, from 0.22% to 25.4%, 20,27 while the incidence of clinically apparent DVT was less than 0.1%. 6,14 To be noted, the preoperative incidence of DVT in patients with closed foot fracture still remains unknown.…”

Profilaxia do tromboembolismo venoso nas cirurgias do tornozelo e do pé

“…For instance, in a prospective cohort study 13 including 114 elective foot and/or ankle surgeries performed on 111 patients, 29 subjects (25.4%) had DVT, but most cases (20/29, or 68.9%) were diagnosed on a screening ultrasound 2 weeks after surgery. 13 In another prospective cohort study, 14 216 patients undergoing miscellaneous foot or ankle surgery were screened for DVT using an ultrasound of the lower limbs 2 to 6 weeks after surgery. The incidence of VTE was of 5.09% (11/216), and 3/11 patients had asymptomatic DVT.…”

“…Como exemplo, cita-se um estudo de coorte prospectivo, 13 no qual 114 cirurgias eletivas em pé e/ou tornozelo foram realizadas em 111 pacientes, sendo constatada TVP em 29 (25,4%), dos quais a maioria (20/29, ou 68,9%) foi diagnosticada por ultrassonografia na visita de rastreamento 2 semanas após a cirurgia. 13 Em outro estudo de coorte prospectivo com 216 pacientes submetidos a abordagens cirúrgicas diversas no pé ou no tornozelo, a TVP foi rastreada por ultrassonografia dos membros inferiores entre 2 e 6 semanas após a cirurgia. A incidência de TEV foi de 5,09% (11/216), e 3 dos 11 pacientes com TEV tiveram TVP assintomática.…”