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Venous thromboembolism in patients with surgically treated ankle fractures

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Objectives

In patients with rotational ankle fracture, we compare the rate of venous thromboembolism development between patients who received chemoprophylaxis vs those patients that received none.

Design

Retrospective cohort study.

Setting

Level I trauma center.

Patients/participants

Between 2014 and 2018, we identified 483 patients with rotational ankle fracture that had no VTE risk factors, were under 70 years of age, and had an isolated injury.

Intervention

Chemoprophylaxis vs no chemoprophylaxis after open reduction internal fixation of a rotational ankle fracture.

Main outcome measurements

Development of VTE was the primary outcome. Secondary outcomes included wound problems, infection, hematoma, or non-union.

Results

There were 313 patients that received no prophylaxis and 170 patients that received chemoprophylaxis after operative fixation of an isolated ankle fracture. Demographics including age, gender, body mass index, and ASA class were similar between groups. The rate of DVT/PE was 3.5% in those without DVT prophylaxis, and 4.1% in those on DVT prophylaxis with no significant differences found (p = 0.8). There was no significant difference in wound complication (no VTE prophylaxis—3.7% vs VTE prophylaxis—2.5%, p = 0.7) or infection rates (no VTE prophylaxis—3.8% vs VTE prophylaxis 4.1%, p = 1.0) between groups.

Conclusions

No difference was detected in the rate of symptomatic DVT or PE in patients based on chemoprophylaxis. Our results support the conclusion that the use of chemoprophylaxis may remain surgeon preference and based on patient risk factors for VTE development.

Level of evidence

Level III—retrospective cohort study.

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Funding

This study received no funding.

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Authors and Affiliations

  1. Department of Orthopaedics, Harborview Medical Center, Seattle, WA, USA

    Iain S. Elliott

  2. Kaiser Permanente San Jose Medical Center, San Jose, CA, USA

    Ajinkya A. Rane

  3. Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA

    Graham J. DeKeyser, Patrick J. Kellam, Phillip T. Dowdle, Tommy M. Safaee, Lucas S. Marchand & Justin M. Haller

Authors
  1. Iain S. Elliott
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  2. Ajinkya A. Rane
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  3. Graham J. DeKeyser
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  4. Patrick J. Kellam
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  5. Phillip T. Dowdle
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  6. Tommy M. Safaee
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  7. Lucas S. Marchand
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  8. Justin M. Haller
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Corresponding author

Correspondence to Justin M. Haller.

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Conflict of interest

Iain S Elliott, Ajinkya A Rane, Graham J DeKeyser, Patrick J Kellam, Phillip T Dowdle, Tommy M Safaee, Lucas S. Marchand have no conflicts of interest specifically relevant to this study. Justin M. Haller is a board or committee member of the Orthopedic Trauma Association and the Western Orthopedic Association. He is a paid consultant for NewClip Technics, Osteocentric, and Stryker.

Ethical approval

The study was conducted under University of Utah IRB 114175.

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Elliott, I.S., Rane, A.A., DeKeyser, G.J. et al. Venous thromboembolism in patients with surgically treated ankle fractures. Arch Orthop Trauma Surg 143, 1237–1242 (2023). https://doi.org/10.1007/s00402-021-04192-5

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  • DOI: https://doi.org/10.1007/s00402-021-04192-5

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