TY - JOUR
T1 - Air plethysmographic assessment of post-traumatic venous function
AU - Fitzgerald, P.
AU - Tierney, S.
AU - Burke, P.
AU - Power, L.
AU - O'Sullivan, T.
AU - Fitzgerald, F.
AU - Grace, P.
AU - Hayes, D. B.
PY - 1994
Y1 - 1994
N2 - Leg swelling is a significant and prolonged problem following ankle fractures. Factors including venous patency and abnormal venous function have been implicated, but a direct correlation has yet to be established. Venous patency, venous pump function and limb swelling were assessed prospectively in thirty-two patients with ankle fractures requiring open reduction, internal fixation and immobilization in plaster. Duplex ultrasonography was used to assess venous patency. Air plethysmography (APG) was used to measure outflow fraction (OF), venous volume (VV), venous filling index (VFI) and parameters of calf muscle pump function-ejection volume fraction (EVF) and residual volume fraction (RVF). Limb swelling was assessed by the difference in ankle circumference measurements between the fracture and uninjured limbs at 6 and 22 cms from lateral mallelous. All parameters were documented in both the injured and uninjured limbs at 5 days, 6, 12, 18 and 24 weeks post injury. Venous patency was normal in all limbs throughout the study period, as assessed by duplex and confirmed by OF. A significant impairment in calf muscle pump function of the fractured limb in comparison to the uninjured limb is demonstrated by a reduction in EVF and increase in RVF at 5 days, 6 and 12 weeks (P < 0.001). At 18 weeks both parameters show a significant improvement for the fractured limb from initial assessment (p < 0.002) that remains unchanged at week 24. Swelling of fractured limb was present throughout the study, gradually decreasing at each assessment. This reduction achieves significance (p < 0.005) at week 18 and is maintained at week 24. This study demonstrates a correlation between limb swelling and abnormal venous pump function, that diminishes on return of calf muscle pump function to normal.
AB - Leg swelling is a significant and prolonged problem following ankle fractures. Factors including venous patency and abnormal venous function have been implicated, but a direct correlation has yet to be established. Venous patency, venous pump function and limb swelling were assessed prospectively in thirty-two patients with ankle fractures requiring open reduction, internal fixation and immobilization in plaster. Duplex ultrasonography was used to assess venous patency. Air plethysmography (APG) was used to measure outflow fraction (OF), venous volume (VV), venous filling index (VFI) and parameters of calf muscle pump function-ejection volume fraction (EVF) and residual volume fraction (RVF). Limb swelling was assessed by the difference in ankle circumference measurements between the fracture and uninjured limbs at 6 and 22 cms from lateral mallelous. All parameters were documented in both the injured and uninjured limbs at 5 days, 6, 12, 18 and 24 weeks post injury. Venous patency was normal in all limbs throughout the study period, as assessed by duplex and confirmed by OF. A significant impairment in calf muscle pump function of the fractured limb in comparison to the uninjured limb is demonstrated by a reduction in EVF and increase in RVF at 5 days, 6 and 12 weeks (P < 0.001). At 18 weeks both parameters show a significant improvement for the fractured limb from initial assessment (p < 0.002) that remains unchanged at week 24. Swelling of fractured limb was present throughout the study, gradually decreasing at each assessment. This reduction achieves significance (p < 0.005) at week 18 and is maintained at week 24. This study demonstrates a correlation between limb swelling and abnormal venous pump function, that diminishes on return of calf muscle pump function to normal.
UR - http://www.scopus.com/inward/record.url?scp=0028218655&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:0028218655
SN - 1044-4122
VL - 18
SP - 80
EP - 84
JO - Journal of Vascular Technology
JF - Journal of Vascular Technology
IS - 2
ER -