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It is unclear whether prophylaxis against venous thromboembolism (VTE) is warranted after orthopedic surgery distal to the knee. In this single-center retrospective study, Boston researchers compared outcomes in 5286 patients who received prophylaxis and the same number of untreated controls who were selected by propensity-score matching. Locations of surgery were forefoot/midfoot (24%), hindfoot/ankle (6%), lower leg between tibial articular surface and malleoli (21%), and more than one location (49%). Prophylactic agents included vitamin K antagonists, direct-acting oral anticoagulants, and heparin-related drugs. Patients using aspirin were excluded (presumably because of concerns about accurate documentation of aspirin use).
Incidence of …