Intermittent pneumatic compression therapy in posttraumatic lower limb edema: Computed tomography and clinical measurements

      This paper is only available as a PDF. To read, Please Download here.


      The purpose of our study was to assess the amount of posttraumatic lower limb edema and its distribution between subcutaneous and subfascial compartments before and after intermittent pneumatic compression (IPC) therapy in patients with fractures of the lower leg immobilized with a cast for six to 12 weeks. Computed tomography (CT) was used as an objective method of measuring the compartmental distribution of edema. Sixteen patients with a mean age of 37 years (range 19 to 64 years) were investigated by clinical measurement of the leg circumference and by CT at the ankle joint and at three equidistant (10cm) levels above it. The unaffected leg served as a control for the evaluation of the amount of edema and density of the tissues. Edema was found primarily in subcutaneous tissue. The IPC treatment decreased relative edema from 23% to 15.9% (p < 0.01) as measured by CT, and from 23.5% to 13.2% as measured clinically. The density of muscle tissue increased 9% (p < 0.01) and that of subcutaneous tissue decreased 5.6% (p < 0.05). The IPC treatment influenced both the amount of edema and the density of tissue compartments.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Stranden E
        • Myhre HO
        The local edema following operations for lower limb atherosclerosis (abstract).
        Acta Chir Scand. 1981; : 77
        • Vaughan BF
        • Slavotinek AH
        • Jepson RP
        Edema of the lower limb after vascular operations.
        Surg Gynecol Obstetr. 1970; 131: 282-290
        • Stranden E
        Comparison between surface measurements and water displacement volumetry for quantification of leg oedema.
        J Oslo City Hosp. 1981; 31: 153-155
        • Termote JL
        • Baert A
        • Crolla D
        • Palmers Y
        • Bulcke JA
        Computed tomography of the normal and pathologic muscular system.
        Radiology. 1980; 137: 439-444
        • Bulcke JAL
        • Herpels V
        Diagnostic value of CT scanning in neuromuscular diseases.
        Radiologe. 1983; 23: 523-528
        • Ingemann-Hansen T
        • Halkjaer-Kristensen J
        Computerized tomographic determination of human thigh components.
        Scand J Rehabil Med. 1980; 12: 27-31
        • Göltner E
        • Gass P
        • Haas JP
        • Schneider P
        The importance of volumetry, lymphscintigraphy and computer tomography in the diagnosis of brachial edema after mastectomy.
        Lymphology. 1988; 21: 134-143
        • Hadjis NS
        • Carr DH
        • Banks L
        • Pflug JJ
        The role of CT in the diagnosis of primary lymphedema of the lower limb.
        Am J Roentgenol. 1985; 144: 361-364
        • Airaksinen O
        Changes in posttraumatic ankle joint mobility, pain and edema following intermittent pneumatic compression therapy.
        Arch Phys Med Rehabil. 1989; 70: 341-344
        • Airaksinen O
        • Kolari PJ
        • Herve R
        • Holopainen R
        Treatment of posttraumatic oedema in lower legs using intermittent pneumatic compression.
        Scand J Rehabil Med. 1988; 20: 25-28
        • Airaksinen O
        • Kolari PJ
        • Ahonen E
        Effect of intermittent pneumatic compression (Ventipress) on post-traumatic oedema and venous outflow.
        in: Partsch H Progress in Lymphology — XI. Elsevier, Amsterdam1988: 579-582
        • Airaksinen O
        • Kolari PJ
        • Airaksinen K
        Relationship between post-traumatic oedema reduction and pain relief.
        in: Nishi M Uchino S Yabuki S Progress in lymphology — XII. Elsevier, Amsterdam1989: 481-484
        • Pekanmäki K
        • Kolari PJ
        • Kiistala U
        Intermittent pneumatic compression treatment for post-thrombotic leg ulcers.
        Clin Exp Dermatol. 1987; 12: 350-353
        • Hull RH
        • Raskob GE
        • Gent M
        • et al.
        Effectiveness of intermittent pneumatic leg compression for preventing deep thrombosis after total hip replacement.
        JAMA. 1990; 263: 2313-2317
        • Pekanmäki K
        • Kolari PJ
        Sequential and graded intermittent pneumatic compression device for treatment of swollen limbs.
        Biomed Tech. 1987; 32: 50-54
        • Gamba JL
        • Silvermann PM
        • Ling D
        • Dunnick NR
        • Korobkin M
        Primary lower extremity lymphedema: CT diagnosis.
        Radiology. 1983; 149: 218
        • Gregl von A
        • Fischer U
        • Heyden D
        • et al.
        Computertomographie und Kernspinto-tomographie beim peripheren Lympödem.
        Fortschrg Röntgenstr. 1985; 143: 219-226
        • Witte CL
        • Witte MH
        • Dumont AE
        Pathophysiology of chronic edema, lymphedema and fibrosis.
        in: Staub NC Taylor AE Edema. Raven Press, New York1984: 521-543
        • Matsen FA
        • Mayo KA
        • Scheridan GW
        • Krugmire RB
        Monitoring of intramuscular pressure.
        Surg. 1976; 79: 702-709
        • Stranden E
        • Enge I
        Computed tomography in the investigation of leg edema following arterial reconstructions.
        Eur J Radiol. 1982; 2: 113-116
        • Földi E
        • Földi M
        • Weissleder H
        Conservative treatment of lymphoedema of the limbs.
        Angiology. 1985; 36: 171-180