Does Foot Surgery Cause Blood Clots?

Advancements to surgical techniques have allowed doctors to fix problems that previously were unable to be solved.  This has led to longer and better quality of life in hundreds of millions of people.  However, surgery is not benign.  There are many potential risks associated with any surgical procedure, and foot surgery is no exception.  One of the many potential risk is the formation of deep vein thrombosis (DVT), otherwise known as a blood clot.  Let’s discuss some of the ways to reduce the risk of forming a DVT.

Before we get too far along, it is important to know that blood clots after foot surgery are very uncommon.  That being said, it is still important to know what can be done to reduce the risk of blood clot formation and how to treat them, since they can have life threatening effects.

Unfortunately, there are some risk factors that we cannot change which increase the risk of DVTs.  Older people tend to be at greater risk than younger people.  Women also are more likely to have a DVT when compared to men.  If you inherited a blood clotting disorder, or something like that runs in your family, you also have increased risk of DVT.  These risk factors cannot be changed, but it is important that you understand their significance before surgery.

Fortunately, there are several risk factors that can be modified so the risk of DVT is lessened.  Obesity, sedentary lifestyle, and use of tobacco are all associated with increased DVT risk.  Specifically with foot surgery, being confined to a bed or wheelchair will immobilize your leg, which decreases blood flow and can increase the risk of DVT.  Thankfully, all of these risk factors can be addressed.  Before surgery, if a person was able to lose weight, increase their activity, and temporarily refrain from using tobacco products before and after the procedure, their risk of DVT would dramatically decrease.

Now that we understand the risk factors associated with blood clots, we will discuss in the next post how to recognize the signs and symptoms and appropriate treatment.

Knock Knees and Bow Legs in Children

As we discussed last time, parents understandably seem to very sensitive to any apparent deformity or perceived imperfection in their children as they develop.  Another common concern for parents is if their children walk with their knees touching or with their legs bowed.  Let’s discuss some of the important points regarding this subject.

Some of the principles we discussed in the toe walking post also apply to this discussion.  Abrupt changes or a sudden deviation from the normal over a short period of time are the best indicator of an underlying problem.  When children are learning to walk, they will find the easiest, most comfortable way to get around.  This tends to not be the most normal looking gait cycle.  Unless they were walking in one way and abruptly change, variations from “normal” should not be alarming.

As a child matures, their bones go through an unwinding process.  This process is called torsion.  As the bones unwind, a child’s gait will slightly alter until the maturation process is a finished.  Depending on the age of the child, their legs will vary from being slightly bow legged to slightly knocked kneed and somewhere in between.    This evolution of the legs tends to resolve at about the age of fourteen, with the legs being straight or very close to it.

Parents should seek medical attention if the deformities are severely exaggerated in either direction.  Most often, severe walking deformities can be expected with some childhood neurological disorders and are often caught close to the birth of the child.  However, they can develop later unexpectedly due to an underlying bone disorder or malnutrition due to malabsorption of a certain nutrient.  These are less common but do happen.

We’ll talk about another pediatric condition in our next post that if treated immediately can be completely reversed without any residual effects.

Clubfeet and their Treatment

Staying in the thread of pediatric conditions, clubfoot is a deformity that should be addressed.  Although it is rarely seen in adolescents and adults in our country, it occurs in about 1 in every 1000 births.  Fortunately, it is recognized very early and treated immediately when seen in the United States.  With immediate appropriate treatment, a person born with clubfoot can expect to walk normally without residual effects.

Clubfoot is when the front of the foot has turned in and wrapped itself around the back of the foot so that if the child were to walk, they would have to bear weight on the thin skin of the top of the foot rather than the thick skin on the bottom of the foot.  The foot is described as being shaped like the letter “C” turned in on itself.  Clubfoot is a deformity seen with some neurological disorders, but more often it is seen simply due to lack of room.  The lack of space pushes the feet up against the wall of the uterus.  When the baby is born, the deformed feet are easily recognized.

Fortunately, a baby’s body is very flexible after it is born, and remains very flexible while the mother is breast feeding.  This flexibility allows us to mold a clubfoot back into proper position without major surgery.  Starting as soon as possible, the baby is put into a series of casts, removed and reapplied each week, which will slowly bring the foot back around so that it will eventually function as a normally.  Within 12 weeks, a severely deformed foot can look completely normal.  The body’s ability to adapt and remodel is incredible at that young age, and we can take advantage of this by immediate treatment.  The babies who do the best are the ones who are treated only hours to days after birth.  If treatment is delayed for weeks or months, the baby may not be flexible enough to resolve the entire deformity.  If this is encountered, surgery may be required for correct the problems.