Jones DL, Jones WA, Fleming KI, et al. - In this prospective cohort study of postoperative adult orthopedic trauma individuals (n = 109) who underwent acute fracture or nonunion surgery of the pelvis, acetabulum, or lower extremity placed on 30 mg of enoxaparin twice daily, researchers ascertained the feasibility and effect of real-time anti-factor Xa (aFXa) level monitoring and enoxaparin dose adjustment in orthopedic trauma, reviewed the sufficiency of standard fixed-dose enoxaparin chemoprophylaxis and investigated whether patient-specific factors affected enoxaparin metabolism. Individuals who were receiving insufficient enoxaparin chemoprophylaxis were at significantly greater risk of 90-day venous thromboembolism. In 43% of postoperative orthopedic trauma individuals, standard fixed-dose enoxaparin gave insufficient chemoprophylaxis, which significantly rose with dose adjustment. Further, deficient enoxaparin prophylaxis was prognosticated by weight, acetabular surgery, and operation length.