DOS 2017

DOS Kongressen 2017 ·

149

A randomized study of in-cast intermittent pneu-

matic foot-compression in the preoperative treat-

ment of malleolar fractures

Henriette Brink Christiansen, Pernille Bovbjerg, Jens Eggers, Jesper O.

Schønnemann

Orthopaedic Clinic, Hospital of Southern Jutland

Background:

Malleolar fractures are often complicated by tissue swelling due

to soft tissue injury, haemorrhage and secondary inflammation. This can lead to

severe oedema and compromise the ability to perform surgery due to blister

formation or the inability to close the skin after surgery. In this situation, the

patient’s operation are typically delayed. To prevent this, studies has shown that

the use of intermittent pneumatic compression (IPC) has the potential benefit

of reducing oedema and tissue swelling.

Purpose / Aim of Study:

The aim of this study was to investigate whether

patients requiring surgery because of malleolar fractures, has a lower diagnosis-

to-surgery time when using IPC, than patients without the IPC.

Materials and Methods:

Patients were randomized to either in- cast IPC or

only cast-immobilization. The attending orthopaedic surgeon decided when the

patient was ready for surgery, and was based on objective findings. The IPC was

used continuously until arrival at the OR and in both groups extremity was el-

evated. Based on prior data we performed a sample size calculation estimating a

power of 80% (â:0,20) and a significance level of 5% (á:0,05) which estimated

a total of 42 patients in each group.

Findings / Results:

In the randomized cohort we included 97 patients, 57

women and 40 men with a mean age of 52 (19-83). 48 were randomized to

both IPC and cast, and 49 to only cast. In the IPC and bandage group there were

an average diagnosis-to-surgery time of 18 hours and in the bandage group 35

hours with a significant difference (P=0.004). We registered 3 delays due to

swelling in the IPC and cast group and 13 delays due to swelling in the cast only

group (P=0.007).

Conclusions:

The use of in-cast intermittent pneumatic foot compression in

this randomized study significantly reduced the diagnosis-to-surgery time.

No conflicts of interest reported

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