Thromboembolic disease after foot and ankle surgery

Background: The incidence and potential life-threatening complications of thromboembolic disease after major orthopaedic surgery has been extensively studied. However, there are two studies pertaining to the incidence of thromboembolic disease after foot and ankle surgery, the findings of which suggest that the incidence is too low to justify routine thromboprophylaxis. Methods: This is a retrospective study identifying the incidence of thromboembolic disease after foot and ankle surgery in the practices of two foot and ankle specialists. The purpose of the study was to evaluate the risk factors for the development of thromboembolic disease and to examine the issue of routine thromboprophylaxis. Six hundred and two patients were included in this study. Results: There was a 4% incidence (24 patients) of postoperative thromboembolic complications. Risk factors identified for postoperative thromboembolic disease were a history of rheumatoid arthritis, a recent history of air travel, previous deep vein thrombosis or pulmonary embolism, and limb immobilization. Conclusions: The incidence of thromboembolic disease after foot and ankle surgery could be higher than that previously reported particularly if a patient has certain risk factors. Prospective randomized clinical trials are needed to establish the true incidence of thromboembolic disease after foot and ankle surgery and to define the indications for routine thromboprophylaxis.