OBJECTIVES: To determine whether the use of a foot pump (intermittent pneumatic pedal compression device) in patients with excessive edema precluding surgery after acute fracture of the calcaneus leads to more rapid resolution of the edema. DESIGN: Prospective randomized setting. Standard hospital in-patient ward at a Level I trauma center. PATIENTS: Those patients with excessive edema precluding operative intervention upon admission after an intraarticular calcaneus fracture who signed an informed consent participated in the study. Twenty-eight patients were enrolled and completed the study: thirteen patients in the foot pump group and fifteen patients in the control group. INTERVENTION: In the control group, patients had a bulky compression dressing, posterior splint, and elevation while awaiting surgery. In the study group, the patients had a foot pump applied to the foot with a posterior splint and elevation while awaiting surgery. MAIN OUTCOME MEASUREMENTS: The volumetric change of the foot at twenty-four-hour intervals for up to seventy-two hours in both the control and study groups. RESULTS: All thirteen patients tolerated the foot pump. The differences in the volume between Day I (baseline) and Day 2 for the foot pump and control groups were minus forty and plus seventy-six milliliters, respectively (p = 0.02). Between Days 1 and 3, the differences were minus ninety-six milliliters for the foot pump group and plus thirty-seven milliliters for the control group (p = 0.02). CONCLUSIONS: A significant progressive decrease in the foot volume was noted during the first forty-eight hours after application of the foot pump in patients with excessive edema precluding operative fixation of a calcaneus fracture upon presentation. The pump was well tolerated by all the patients in the study group. Thus, we believe the pump serves as a useful adjunct in the preoperative edema resolution following these complicated fractures.
RCT Entities:
OBJECTIVES: To determine whether the use of a foot pump (intermittent pneumatic pedal compression device) in patients with excessive edema precluding surgery after acute fracture of the calcaneus leads to more rapid resolution of the edema. DESIGN: Prospective randomized setting. Standard hospital in-patient ward at a Level I trauma center. PATIENTS: Those patients with excessive edema precluding operative intervention upon admission after an intraarticular calcaneus fracture who signed an informed consent participated in the study. Twenty-eight patients were enrolled and completed the study: thirteen patients in the foot pump group and fifteen patients in the control group. INTERVENTION: In the control group, patients had a bulky compression dressing, posterior splint, and elevation while awaiting surgery. In the study group, the patients had a foot pump applied to the foot with a posterior splint and elevation while awaiting surgery. MAIN OUTCOME MEASUREMENTS: The volumetric change of the foot at twenty-four-hour intervals for up to seventy-two hours in both the control and study groups. RESULTS: All thirteen patients tolerated the foot pump. The differences in the volume between Day I (baseline) and Day 2 for the foot pump and control groups were minus forty and plus seventy-six milliliters, respectively (p = 0.02). Between Days 1 and 3, the differences were minus ninety-six milliliters for the foot pump group and plus thirty-seven milliliters for the control group (p = 0.02). CONCLUSIONS: A significant progressive decrease in the foot volume was noted during the first forty-eight hours after application of the foot pump in patients with excessive edema precluding operative fixation of a calcaneus fracture upon presentation. The pump was well tolerated by all the patients in the study group. Thus, we believe the pump serves as a useful adjunct in the preoperative edema resolution following these complicated fractures.
Authors: C Schwahn-Schreiber; F X Breu; E Rabe; I Buschmann; W Döller; G R Lulay; A Miller; E Valesky; S Reich-Schupke Journal: Hautarzt Date: 2018-08 Impact factor: 0.751