SHAP ranked D-dimer and age as dominant with non-linear effects; higher C-reactive protein and erythrocyte sedimentation rate, lower prognostic nutritional index, advanced Schatzker types, and smoking increased risk.<h4>Conclusion</h4>An interpretable XGBoost model based on routine preoperative variables identifies TPF patients at high risk of preoperative DVT and may guide ultrasound triage and perioperative management. This evidence concerns the gene CRP and deep vein thrombosis.