Introduction
upper extremity fractures, fractures, Soft-tissue swelling, pain
COMPLICATION
Soft-tissue swelling in the setting of complex joint fractures is a critical factor in clinical managementThis impairs wound and bone healing, and the accumulation of metabolites causes increased painHowever, all these measures have a purely passive effect, by lowering the hydrostatic pressure, and are therefore both lengthy and only effective as long as they are consistently applied. In the 1970s, a venous plexus was demonstrated for both venous return from the foot and hand. Their physiology was proven in further studies using phlebography and duplex sonographySynergistically with this passive moiety, the blood from the deep intermuscular veins in both regions is actively transported centrally by muscle pumpsOnly a few studies exist for other anatomical locations, further proximal on the lower leg and tibial plateau, as well as for joint fractures of the upper extremity. Their validity is further limited by methodological weaknesses, small case numbers or only a limited indicationTherefore, and due to the lack of evidence for upper extremity fractures, the benefit of VIT therapy in complex fractures of the lower leg and the upper extremity was investigated with regard to decongestion, perioperative length of stay, pain intensity and medication, and complication and revision rates. It was hypothesized that VIT therapy would reduce the time in days until operability was achieved.