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Venous Thrombosis After Hallux Valgus Surgery

Investigation performed at the University of Graz, Graz, Austria

Roman Radl, MD
Norbert Kastner, MD
Christian Aigner, MD
Horst Portugaller, MD
Herbert Schreyer, MD
Reinhard Windhager, MD
Departments of Orthopaedic Surgery (R.R., N.K., C.A., and R.W.) and Radiology (H.P. and H.S.), University of Graz, Auenbruggerplatz 9, 8036 Graz, Austria. E-mail address for R. Radl: roman.radl{at}uni-graz.at

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Although surgery for the treatment of hallux valgus is frequently performed, the exact rate of deep vein thrombosis following this procedure is unknown. We performed a single-center, prospective, phlebographically controlled study to quantify the rate of venous thrombosis following operative correction of hallux valgus.

Methods: Consecutive patients undergoing chevron bunionectomy for correction of hallux valgus deformity were enrolled in the study. Patients with clinical or hematological risk factors for venous thrombosis were excluded. One hundred patients with a mean age of 48.9 years were operated on and did not receive medical prophylaxis against thrombosis. All patients were assessed with phlebography at a mean of twenty-nine days postoperatively.

Results: Venous thrombosis was found in four patients (4%). The mean age of these patients (and standard deviation) was 61.7 ± 6.1 years compared with a mean age of 48.4 ± 13.9 years for the patients in whom thrombosis did not develop (p = 0.034).

Conclusions: Patients are at a low risk for venous thrombosis following surgical treatment of hallux valgus. The need for prophylaxis against thrombosis should be calculated individually for each patient according to his or her known level of risk. Routine medical prophylaxis against thrombosis might be justified for patients over the age of sixty years.

Level of Evidence: Prognostic study, Level I-1 (prospective study). See Instructions to Authors for a complete description of levels of evidence.

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