The Use of a Pneumatic Intermittent Impulse Compression Device in the Treatment of Calcaneus Fractures

Abstract

To determine the effects of intermittent compression on foot swelling, intracompartmental pressures, and hospital stay associated with acute calcaneus fractures, we retrospectively reviewed the records of 55 patients between January 1990 and July 1992 whose management profile included preoperative use of an intermittent compression foot pump and surgical treatment by open reduction and internal fixation. Average times were: injury to admission, 6.04 days; admission to surgery, 1.35 days; and surgery to discharge, 3.38 days. Hospital stay averaged 4.73 days. In 27 patients with suspected compartmental ischemia, admission and preoperative pressures in three compartments were averaged and compared: 18.22 and 3.81 mm Hg, respectively (p < 0.001). The authors concluded that the intermittent compression pump appears to rapidly reduce swelling of the foot and decrease elevated compartment pressures associated with calcaneus fractures, which may play a role in decreasing hospital stay.

Effective Treatment of Posttraumatic and Postoperative Edema in Patients with Ankle and Hindfoot Fractures

“…Lack of blinding 21 , or the use of unvalidated outcomes measurements, as seen in previous studies [18][19][20][21][22][23] , might also have contributed to the controversial findings of our study as compared with others. In our study, blinding was successful in approximately 91% of the measurements.…”

“…We suspect that positioning of the limb (with or without elevation) during impulse compression sessions and in off-session periods and the addition of a compressive force, as applied, for example, by stockinette, play an important role. There is a lack of precise description of the impulse compression application and its co-interventions in prior studies [18][19][20][21][22][23] , making comparisons of the results difficult. We believe that limb positioning and any sort of compression are potential confounders in clinical investigations.…”

“…Multilayer compression bandaging has been used in our hospital with positive effects in treating edema in patients with trauma. Various publications [18][19][20][21][22][23] also suggest the use of intermittent impulse compression devices in reducing traumatic edema. These devices contain an inflatable pad that intermittently applies pressure to the plantar arch of the foot to compress the concomitant veins and lymphatic vessels of the lateral plantar artery, thereby enhancing venous backflow 24,25 .…”

Wave Plate Osteosynthesis of Calcaneal Fractures

“…In many cases it is possible to safely surgically address the calcaneal fracture the same week that the injury occurred without the use of specialized protocols to expedite resolution of the swelling. 10 Other advantages of early surgery are that the fracture fragments are much more easily mobilized and reduced and resorption at the fracture sites is avoided. Also, there is no soft tissue contracture that occurs hindering the reduction and potentially placing the soft tissue envelope at risk.…”

Vascular Impulse Technology versus elevation in the treatment of posttraumatic swelling of extremity fractures: study protocol for a randomized controlled trial

“…There are five more studies available in the medical literature that examined the clinical advantage of impulse foot-pump devices and these were published between 1993 and 2000 [ 10 , 13 , 14 , 21 , 22 ]. These studies have significant limitations, as only patients with fractures of the ankle and the calcaneus have been included.…”