Vascular Impulse Technology vs. Elevation for the Reduction of Swelling of Upper and Lower Extremity Joint Fractures – Results of a Prospective Randomised Controlled Trial

Introduction Soft tissue conditioning due to posttraumatic oedema after complicated joint fractures is a central therapeutic aspect both pre- and postoperatively. Six to ten days are passing on average until the patient is suitable for surgery. The aim was to compare the decongestant effect of vascular impulse technology (VIT) with that of conventional elevation. Materials and Methods In this monocentric RCT, 68 patients with joint fractures of the upper (n = 36) and lower (n = 32) extremity were included and randomised after consent in a 1:1 ratio. The variables were evaluated for all fractures together and additionally subdivided into upper or lower extremity for better clinical comparability. The 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. Results 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), being statistically significant with 1.7 (95% CI: 0.1; 3.3) days in the as-treated sensitivity analysis (pAT = 0.038). Significant less pain was found in the intervention group and a significantly faster oedema reduction. Due to rare occurrences, nothing can be derived in regard to complications and revisions. Conclusion Administration of VIT therapy did not lead to a significant reduction in the time until operability but was superior to elevation in regard of soft tissue conditioning and pain reduction. Thus, it seems like 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.