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Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures

Soft-tissue conditioning due to posttraumatic oedema after complicated joint fractures is a central therapeutic aspect both pre- and postoperatively. On average, 6–10 days pass until the patient is suitable for surgery. This study compares the decongestant effect of vascular impulse technology (VIT)...

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Autores principales: El Barbari, Jan S., Schnetzke, Marc, Bergmann, Moritz B., Baumann, Lukas, Vetter, Sven Y., Swartman, Benedict, Grützner, Paul A., Franke, Jochen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837119/
https://www.ncbi.nlm.nih.gov/pubmed/36635339
http://dx.doi.org/10.1038/s41598-022-27231-6
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author El Barbari, Jan S.
Schnetzke, Marc
Bergmann, Moritz B.
Baumann, Lukas
Vetter, Sven Y.
Swartman, Benedict
Grützner, Paul A.
Franke, Jochen
author_facet El Barbari, Jan S.
Schnetzke, Marc
Bergmann, Moritz B.
Baumann, Lukas
Vetter, Sven Y.
Swartman, Benedict
Grützner, Paul A.
Franke, Jochen
author_sort El Barbari, Jan S.
collection PubMed
description Soft-tissue conditioning due to posttraumatic oedema after complicated joint fractures is a central therapeutic aspect both pre- and postoperatively. On average, 6–10 days pass until the patient is suitable for surgery. This study compares the decongestant effect of vascular impulse technology (VIT) with that of conventional elevation. In this monocentric RCT, 68 patients with joint fractures of the upper (n = 36) and lower (n = 32) extremity were included and randomized after consent in a 1:1 ratio. Variables were evaluated for all fractures together and additionally subdivided into upper or lower extremity for better clinical comparability. Primary endpoint was the time in days from hospital admission to operability. Secondary endpoints were total length of stay, oedema reduction, pain intensity, complications, and revisions. The time from admission until operability was reduced by 1.4 (95% CI − 0.4; 3.1) days in the mITT analysis (p = 0.120) and was statistically significant with 1.7 (95% CI 0.1; 3.3) days in the as-treated sensitivity analysis (p(AT) = 0.038). Significantly less pain and a faster oedema reduction were found in the intervention group. Due to rare occurrences, nothing can be concluded regarding complications and revisions. Administration of VIT therapy did not lead to a significant reduction in time until operability in the whole population but was superior to elevation for soft-tissue conditioning and pain reduction. However, there was a significant reduction by 2.5 days (95% CI 0.7; 4.3) in the subgroup of lower extremity fractures. VIT therapy therefore seems to be a helpful tool in the treatment of posttraumatic oedema after complex joint fractures of the lower and upper extremity, especially in tibial head and lower leg fractures.
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spelling pubmed-98371192023-01-14 Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures El Barbari, Jan S. Schnetzke, Marc Bergmann, Moritz B. Baumann, Lukas Vetter, Sven Y. Swartman, Benedict Grützner, Paul A. Franke, Jochen Sci Rep Article Soft-tissue conditioning due to posttraumatic oedema after complicated joint fractures is a central therapeutic aspect both pre- and postoperatively. On average, 6–10 days pass until the patient is suitable for surgery. This study compares the decongestant effect of vascular impulse technology (VIT) with that of conventional elevation. In this monocentric RCT, 68 patients with joint fractures of the upper (n = 36) and lower (n = 32) extremity were included and randomized after consent in a 1:1 ratio. Variables were evaluated for all fractures together and additionally subdivided into upper or lower extremity for better clinical comparability. Primary endpoint was the time in days from hospital admission to operability. Secondary endpoints were total length of stay, oedema reduction, pain intensity, complications, and revisions. The time from admission until operability was reduced by 1.4 (95% CI − 0.4; 3.1) days in the mITT analysis (p = 0.120) and was statistically significant with 1.7 (95% CI 0.1; 3.3) days in the as-treated sensitivity analysis (p(AT) = 0.038). Significantly less pain and a faster oedema reduction were found in the intervention group. Due to rare occurrences, nothing can be concluded regarding complications and revisions. Administration of VIT therapy did not lead to a significant reduction in time until operability in the whole population but was superior to elevation for soft-tissue conditioning and pain reduction. However, there was a significant reduction by 2.5 days (95% CI 0.7; 4.3) in the subgroup of lower extremity fractures. VIT therapy therefore seems to be a helpful tool in the treatment of posttraumatic oedema after complex joint fractures of the lower and upper extremity, especially in tibial head and lower leg fractures. Nature Publishing Group UK 2023-01-12 /pmc/articles/PMC9837119/ /pubmed/36635339 http://dx.doi.org/10.1038/s41598-022-27231-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
El Barbari, Jan S.
Schnetzke, Marc
Bergmann, Moritz B.
Baumann, Lukas
Vetter, Sven Y.
Swartman, Benedict
Grützner, Paul A.
Franke, Jochen
Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures
title Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures
title_full Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures
title_fullStr Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures
title_full_unstemmed Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures
title_short Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures
title_sort vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837119/
https://www.ncbi.nlm.nih.gov/pubmed/36635339
http://dx.doi.org/10.1038/s41598-022-27231-6
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