Managing Lymphedema in Fracture Care

Current Concepts and Treatment Principles

Christopher Thomas, DO; Jessica T. Le, DO; Emily Benson, MD


J Am Acad Orthop Surg. 2020;28(18):737-741. 

In This Article


Lymphedema is a major problem worldwide. In the United States, lymphedema is reported to affect as many as 3 million people. Lymphedema more commonly affects women compared with men.[8] The development of lymphedema can be classified as either primary or secondary. Primary lymphedema is because of congenital or inherited conditions that result in the pathologic development of lymphatic vessels, otherwise known as lymphangiodysplasia.[9–11] Although primary lymphedema is rare, it has an estimated prevalence of 1 in 100, 000 individuals, occurring most commonly in children.[12] Secondary lymphedema occurs after other conditions or treatments that lead to damage or obstruction of previously normal lymphatic vessels, including infection, inflammation, radiation, cancer treatment, and trauma.[2,10] The estimated prevalence of secondary lymphedema is 1 in 1,000 individuals, with the average age between 50 and 58 years. In relation to lymphedema of the extremities, lower extremity edema is more common than upper extremity lymphedema and known risk factors include the following: trauma, infection, and obesity.[8] Orthopaedic surgeons frequently treating fractures due to trauma may see patients at risk for secondary lymphedema more commonly.