Managing Lymphedema in Fracture Care

Current Concepts and Treatment Principles

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

Disclosures

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

In This Article

Summary

Lymphedema is common after mechanical injury to bone and surrounding soft tissues. To help ensure adequate healing of fractures, orthopaedic surgeons must recognize and diagnose lymphedema early and initiate prompt management. Arslan et al[3] demonstrated the inhibitory function that lymphedema expresses in bone formation and on osteogenic cells in fracture healing.[3] The management of lymphedema is complex and challenging. The use of continuous compression and decongestive therapy are proven methods for reducing fluid accumulation in tissues distal to fracture sites. These methods require the patient to be vigilant with their use of compression bandages and garments to ensure effective reduction of fluid accumulation in tissues. This will help facilitate the return of lymphatic fluid back to the circulation to be processed and promote proper bone formation. In patients who fail conservative therapies, surgical treatment and intervention may offer definitive management, but these techniques require additional investigation with randomized controlled trials to fully elucidate outcomes and long-term efficacy.

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