This retrospective analysis was prompted by the authors’ observation of the relatively high incidence of venous thromboembolism (VTE) in the surgical repair of acute Achilles tendon ruptures.
88 patients were treated surgically for an acute Achilles tendon rupture. No prophylactic anticoagulation was given to any patients. The incidence of VTE was then reviewed retrospectively.
Five patients developed symptomatic deep vein thrombosis (5,7%) and one a near-fatal pulmonary embolus (1.1%). There were no major bleeding or cardiovascular adverse events. One patient developed a thrombus of the lesser saphenous vein (1.1%) and there was one superficial sepsis (1.1%). A temporary peroneal nerve palsy occurred in one patient (1.1%). There were two re-ruptures (2.3%).
There is no doubt that thromboprophylaxis must be given to the high risk patient and is also recommended for major orthopaedic surgery. Limited data is available for the use of thromboprophylaxis in foot and ankle surgery. In light of the unacceptably high incidence of venous thromboembolism in this study, the authors suggest that routine venous thromboembolism prophylaxis should be considered for these patients.
Level of evidence
Therapeutic study, Level III (retrospective study).
Keywords: Venous thromboembolism; Acute Achilles tendon rupture
Nikiforos Pandelis Saragas M.B.B.Ch. (Wits), F.C.S. (S.A.) Ortho, M.Med. (Ortho Surg) (Wits)a, b, , , and Paulo Norberto Faria Ferrao M.B.Ch.B. (Pret), F.C.S. (S.A.) Orthoa, b
a Netcare Linksfield Orthopaedic Sports & Rehabilitation Centre (Clinic), Johannesburg, South Africa
b Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa