Chirurgia del piede mininvasiva e tromboprofilassi

Abstract

Thromboembolic prophylaxis in patients undergoing minimally invasive surgery of the foot is still debated and the behaviour of orthopaedic surgeons is somewhat controversial, due to the current lack of scientific evidence and/or recommendations among different Foot Surgery Societies. The aim of the study was to depict the relevant literature concerning the epidemiology of thromboembolic events (TVE) in this surgical field: the incidence of deep venous thrombosis (DVT) varied between 0.2–4%, and that of non-fatal pulmonary embolism was 0.15%. DVT involves the deep distal vessels in almost all cases. Some risk factors for the onset of DVT have been identified: postoperative immobilisation, hindfoot surgery, the time of ischaemia, and older age. The protocol adopted at our hospital is presented here, suggesting that prophylaxis is not advisable in all patients undergoing minimally invasive foot surgery, but only in patients older than 40 years of age and/or in case of concomitant specific risk factors for TVE.