Which scoring system is used to assess the risk of venous thromboembolism in foot and ankle surgery?

• A. Wells score
• B. Apgar score
• C. AOFAS score
• D. Lysholm score

Answer: (A)

The key idea is using a clinical prediction rule to gauge the chance of a venous thromboembolism in the setting of foot and ankle surgery. The Wells scoring system is designed to estimate the pretest probability of deep vein thrombosis (and, by extension, venous thromboembolism) based on symptoms, signs, and risk factors such as leg swelling, tenderness along the deep venous system, immobilization or recent surgery, prior DVT, and other clues. In a patient about to or having undergone foot and ankle surgery, applying this score helps decide whether further testing (like duplex ultrasound) is needed and whether VTE prophylaxis should be used.

The other options don’t fit this purpose. The Apgar score is an assessment used right after birth to gauge newborn vitality. The AOFAS score and Lysholm score are functional outcome measures for the foot/ankle and knee, respectively, not tools for evaluating the risk of blood clots.