Vascular impulse technology versus elevation for the reduction of swelling of lower extremity joint fractures: results of a prospective randomized controlled study
AimsComplex joint fractures of the lower extremity are often accompanied by soft-tissue swelling and are associated with prolonged hospitalization and soft-tissue complications. The aim of the study was to evaluate the effect of vascular impulse technology (VIT) on soft-tissue conditioning in compar...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
1 Apr 2021
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| In: |
The bone & joint journal
Year: 2021, Volume: 103-B, Issue: 4, Pages: 746-754 |
| ISSN: | 2049-4408 |
| DOI: | 10.1302/0301-620X.103B4.BJJ-2020-1260.R1 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1302/0301-620X.103B4.BJJ-2020-1260.R1 Verlag, lizenzpflichtig, Volltext: https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.103B4.BJJ-2020-1260.R1 
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| Author Notes: | Marc Schnetzke, Jan El Barbari, Svenja Schüler, Benedict Swartman, Holger Keil, Sven Vetter, Paul Alfred Gruetzner, Jochen Franke |
| Summary: | AimsComplex joint fractures of the lower extremity are often accompanied by soft-tissue swelling and are associated with prolonged hospitalization and soft-tissue complications. The aim of the study was to evaluate the effect of vascular impulse technology (VIT) on soft-tissue conditioning in comparison with conventional elevation.MethodsA total of 100 patients were included in this prospective, randomized, controlled monocentre study allocated to the three subgroups of dislocated ankle fracture (n = 40), pilon fracture (n = 20), and intra-articular calcaneal fracture (n = 40). Patients were randomized to the two study groups in a 1:1 ratio. The effectiveness of VIT (intervention) compared with elevation (control) was analyzed separately for the whole study population and for the three subgroups. The primary endpoint was the time from admission until operability (in days).ResultsThe mean length of time until operability was 8.2 days (SD 3.0) in the intervention group and 10.2 days (SD 3.7) in the control group across all three fractures groups combined (p = 0.004). An analysis of the subgroups revealed that a significant reduction in the time to operability was achieved in two of the three: with 8.6 days (SD 2.2) versus 10.6 days (SD 3.6) in ankle fractures (p = 0.043), 9.8 days (SD 4.1) versus 12.5 days (SD 5.1) in pilon fractures (p = 0.205), and 7.0 days (SD 2.6) versus 8.4 days (SD 1.5) in calcaneal fractures (p = 0.043). A lower length of stay (p = 0.007), a reduction in pain (ppreop = 0.05; pdischarge < 0.001) and need for narcotics (ppreop = 0.064; ppostop = 0.072), an increased reduction in swelling (p < 0.001), and a lower revision rate (p = 0.044) could also be seen, and a trend towards fewer complications (p = 0.216) became apparent.ConclusionCompared with elevation, VIT results in a significant reduction in the time to achieve operability in complex joint fractures of the lower limb.Cite this article: Bone Joint J 2021;103-B(4):746-754. |
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| Item Description: | Gesehen am 17.05.2021 |
| Physical Description: | Online Resource |
| ISSN: | 2049-4408 |
| DOI: | 10.1302/0301-620X.103B4.BJJ-2020-1260.R1 |