Effect of Chemical Thromboprophylaxis on the Rate of Venous Thromboembolism After Treatment of Foot and Ankle Fractures

814 patients scheduled for surgical fixation of open or closed fractures of the ankle or foot were randomized to 14-day thromboprophylaxis with subcutaneous low molecular weight heparin, or to placebo with subcutaneous saline. The purpose of this study was to determine if routine low molecular weight heparin significantly reduced the incidence of venous thromboembolic (VTE) complications. Results demonstrated an overall low incidence of VTE in both groups, with no significant difference between groups. All VTE complications were cases of asymptomatic deep vein thrombosis; no cases of pulmonary embolism were documented. It should be noted that a formal sample size calculation was not performed prior to the initiation of this study and that it may have been underpowered to detect differences between groups.