Aloisi D.Cantelli.P.L. Mingardi L
Trattamento del linfedema degli arti inferiori con pressotherapia pneumatica
Minerva Cardioangiologica 1999;Vol 47 N11,,499-500

Department of Orthopaedics, University of Southern California, Los Angeles, USA.
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.