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· DOS Abstracts
Preoperative in-cast intermittent pneumatic
compression of malleolar fractures
Jesper Schønnemann, Rasmus Buck Bendtson
Orthopedic, sygehus sønderjylland, Aabenraa
Background:
Malleolar fractures are often complicated by tissue swelling due
to soft tissue injury, haemorrhage and secondary inflammation. In these situa-
tions the patients operation is typically delayed until it is safe to operate again. In
order to prevent delay for surgery, studies has shown that the use of intermit-
tent pneumatic compression (IPC) has the potential benefit of reducing oedema
and tissue swelling.
Purpose / Aim of Study:
In a prospective patient cohort measure diagnosis-
to-surgery time when using IPC, and comparing it to a similar retrospective
patient cohort.
Materials and Methods:
For a 3 month period all patients admitted at Sygehus
Sønderjylland, Åbenrå orthopedic department requiring surgery because of
malleolar fractures will be fitted with IPC (Flowtron footcompression bandage)
in the Emergency Department after, if necessary, reposition, and then a cast.
The time for diagnosis-to-surgery will be registered as primary outcome. The
data collected in the three month period will be compared to the similar data
from the department’s treatment of malleolar fractures one year prior to the
start of this study.
Findings / Results:
In the prospective cohort we included 17 patients, mean
age 55(24-93) with an average diagnosis-to surgery time of 12 (3-26) hours.
No patients were delayed due to swelling. In the retrospective cohort we identi-
fied 15 patients, mean age 63(20-89) ) with an average diagnosis-to surgery
time of 42(4-138) hours. Three patients were delayed due to swelling.
Conclusions:
The use of in-cast intermittent pneumatic compression (IPC),
may have an influence on swelling after a malleolar fracture, and has the poten-
tial benefit of reducing the diagnosis-to-surgery time. Further research should
include a randomized study.
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