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Managing Lymphedema in Fracture Care: Current Concepts and Treatment Principles.

Authors :
Thomas C
Le JT
Benson E
Source :
The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2020 Sep 15; Vol. 28 (18), pp. 737-741.
Publication Year :
2020

Abstract

Lymphatic flow plays a notable role in the regulation of bone formation and remodeling. Chronic accumulation of the lymph fluid within tissues may lead to issues with proper bone healing after fractures, emphasizing the importance of proper management of lymphedema after trauma. Many associated risk factors place patients at risk for lymphedema, including previous surgery with nodal dissection, radiation therapy, infection, malignancy, family history of congenital lymphedema, and trauma. The benchmark imaging technique for the diagnosis of lymphedema is lymphoscintigraphy. Other modalities include duplex ultrasonography, CT, and MRI. First-line conservative treatment of lymphedema is compression. Complete decongestive therapy or complex physical therapy, also known as decongestive lymphatic therapy (DLT), has shown positive results in reducing lymphedema. Surgical interventions aim to either reconstruct and restore function of the lymphatic system or debulk and reduce tissues and fluids. Understanding the significance of lymphedema on bone healing and techniques available to recognize it are important factors in preventing delay in diagnosis and ensuring proper management of lymphedema after trauma.

Details

Language :
English
ISSN :
1940-5480
Volume :
28
Issue :
18
Database :
MEDLINE
Journal :
The Journal of the American Academy of Orthopaedic Surgeons
Publication Type :
Academic Journal
Accession number :
32618680
Full Text :
https://doi.org/10.5435/JAAOS-D-19-00722