Effective Treatment of Posttraumatic and Postoperative Edema

Effective Treatment of Posttraumatic and Postoperative Edema in Patients With Ankle- and Hindfoot Fractures. A Randomized Controlled Trial Comparing Multi-layer Compression Therapy and A-V Impulse Compression to the Standard Treatment With Ice

Edema control after ankle- and hindfoot fractures is important. Multi-layer compression bandages or A-V Impulse compression may are more effective in reducing edema than ice.

After ankle- and hindfoot fractures, edema has a major impact on the time point of surgical intervention and may increases the risk of wound complications and infection postoperatively. Effective treatment of edema, therefore, is of great importance. The aim of this study was to evaluate the efficacy of the multi-layer compression therapy and of the A-V Impulse compression (AVI) in reducing ankle- and hindfoot edema as compared to the standard treatment with ice.

Inclusion criteria:

• Age 18-65 years

• Inpatients

• Acute ankle- or hindfoot fractures (malleolar-, calcaneus-, talus-, and pilon- tibial fractures) including fractures temporary stabilized with an external fixator)

• No walking aids before trauma

• Written informed consent

• Monotrauma

• Preoperative and/or postoperative edema

• Preoperative inclusion

  • if delay of surgery due to ankle edema
  • if fracture stable enough for temporary removal of orthesis

Exclusion criteria:

• Diabetes Mellitus
• Lymphedema
• Peripheral arterial occlusive disease (PAD)
• Decompensated heart failure or renal insufficiency
• Acute bacterial infection
• Severe osteoporosis
• Pathological fractures
• Known tumors
• Postthrombotic syndrome
• Thrombosis
• Open fractures
• Polytrauma, cerebral trauma
• Neurological deficiencies
• Diuretics
• Pregnancy
• Alcohol or drug abuse
• Psychological disorders