{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T09:53:04Z","timestamp":1773309184295,"version":"3.50.1"},"reference-count":9,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPMA"],"abstract":"<jats:p>Venothromboembolic (VTE) events are considered rare complications following foot and ankle surgery. Most instances of VTE following surgical procedures occur in particularly high-risk patient populations; therefore, VTE prophylactic anticoagulation is initiated based on risk\/benefit stratification for each individual patient undergoing foot and ankle surgery. We present a case report on a 40-year-old male who underwent isolated Lisfranc ligament repair and subsequently developed an acute saddle pulmonary embolism and deep vein thrombosis 1 month postoperatively. The patient was on prophylactic Lovenox, yet still developed a life-threatening complication. The patient was found to be on a selective estrogen receptor modulator for the off-label treatment of male infertility. This medication, surgical intervention, and a period of non-weight bearing are believed to be contributory to the patient\u2019s relatively increased hypercoagulable state. This case depicts a rare complication of foot and ankle surgery and highlights the importance of VTE prophylaxis during the postoperative period.<\/jats:p>","DOI":"10.3390\/japma116020012","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:32:09Z","timestamp":1773243129000},"page":"12","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Saddle Pulmonary Embolism and Deep Vein Thrombosis Following Foot and Ankle Surgery While on Prophylactic Lovenox: A Case Report"],"prefix":"10.3390","volume":"116","author":[{"given":"Sara J.","family":"Judickas","sequence":"first","affiliation":[{"name":"Grant Medical Center, 111 S. Grant Ave., Columbus, OH 43215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3021-9989","authenticated-orcid":false,"given":"Joseph R.","family":"Brown","sequence":"additional","affiliation":[{"name":"Washington Orthopedic Center, 1900 Cooks Hill Rd., Centralia, WA 98531, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5801-4179","authenticated-orcid":false,"given":"Robert W.","family":"Mendicino","sequence":"additional","affiliation":[{"name":"St. Clair Medical Group Orthopedic Surgery, 1000 Bower Hill Rd. Suite 7300, Pittsburgh, PA 15243, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref_1","unstructured":"Kushner, A., West, W.P., Khan Suheb, M.Z., and Pillarisetty, L.S. (2023, August 18). Virchow Triad, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK539697\/."},{"key":"ref_2","unstructured":"McLendon, K., Goyal, A., and Attia, M. (2023, August 18). Deep Venous Thrombosis Risk Factors, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470215\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1053\/j.jfas.2011.10.017","article-title":"Incidence of acute deep vein thrombosis and pulmonary embolism in foot and ankle trauma: Analysis of the National Trauma Data Bank","volume":"51","author":"Shibuya","year":"2012","journal-title":"J. Foot Ankle Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1302\/0301-620X.94B2.27579","article-title":"Incidence of venous thromboembolism in elective foot and ankle surgery with and without aspirin prophylaxis","volume":"94","author":"Griffiths","year":"2012","journal-title":"J. Bone Joint Surg. Br."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1302\/0301-620X.93B4.25731","article-title":"Venous thromboembolic events following foot and ankle surgery in the English National Health Service","volume":"93","author":"Jameson","year":"2011","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1177\/107110070202300507","article-title":"Incidence of DVT following surgery of the foot and ankle","volume":"23","author":"Solis","year":"2002","journal-title":"Foot Ankle Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1053\/j.jfas.2015.02.022","article-title":"American College of Foot and Ankle Surgeons\u2019 clinical consensus statement: Risk, prevention, and diagnosis of venous thromboembolism disease in foot and ankle surgery and injuries requiring immobilization","volume":"54","author":"Fleischer","year":"2015","journal-title":"J. Foot Ankle Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1586\/erc.10.160","article-title":"Prevention of venous thromboembolism in obesity","volume":"8","author":"Freeman","year":"2010","journal-title":"Expert. Rev. Cardiovasc. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.urology.2018.11.009","article-title":"Medical Treatments for Hypogonadism do not Significantly Increase the Risk of Deep Vein Thrombosis Over General Population Risk","volume":"124","author":"Kavoussi","year":"2019","journal-title":"Urology"}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1930-8264\/116\/2\/12\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:40:27Z","timestamp":1773243627000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/116\/2\/12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["japma116020012"],"URL":"https:\/\/doi.org\/10.3390\/japma116020012","relation":{},"ISSN":["1930-8264"],"issn-type":[{"value":"1930-8264","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]}}}