Pulmonary Embolism following a Foot Injury or Surgery

What is a Pulmonary Embolism (PE)?

A pulmonary embolism, also called a “PE”, is a very serious and potentially fatal condition that occurs when a blood clot forms in the deep veins of the leg or pelvis area and then breaks off (forms an “embolus”) and travels to the lungs. It then gets lodged in one of the pulmonary arteries preventing blood flow to that area of the lungs.

What are the risk factors?

Risk factors include:

• Having a previous PE or blood clot
• A first-degree family member who has had a PE (some patients have a genetic predisposition)
• Smoking
• Birth control pills
• Obesity
• Immobilization in a lower leg cast
• Prolonged surgery time
• Relative Immobilization (e.g. airplane travel)

Risk of Pulmonary Embolism with Foot or Ankle injury or surgery

Unlike patients who have major hip (ex. hip fracture or Hip replacement) or knee (ex. knee replacement) injuries or surgery the chance of developing a pulmonary embolism following a foot injury or surgery is usually quite low. However, it is not zero!  Patients who have had a previous pulmonary embolism or who have a family history of a PE are at much higher risk. The physician treating a patient with a foot or ankle injury or surgery may recommend “prophylaxis” -a treatment to lower the likelihood of developing a pulmonary embolism. Typical prophylaxis to try and prevent a PE includes “thinning” the patients blood with aspirin (ASA) or another blood thinner. In addition, early movement of the body following an injury or surgery can serve to minimize the risk of a PE. Patients should discuss their individual risk of a PE with their treating physician especially if they are planning on flying shortly after their injury or surgery. The immobility associated with sitting in an airplane seat for an extended period of time can further increase the likelihood of a patient developing a PE.

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