To determine whether the use of a foot pump
(intermittent pneumatic pedal compression device) in patients with excessive edema
precluding surgery after acute fracture of the calcaneus leads to more rapid resolution of the edema
Prospective randomized setting. Standard hospital inpatient ward at a Level I trauma center.
Those patients with excessive edema
precluding operative intervention upon admission after an intraarticular calcaneus fracture
who signed an informed consent participated in the study. Twenty-eight patients were enrolled and completed the study: thirteen patients in the foot pump
group and fifteen patients in the control group.
In the control group, patients had a bulky compression dressing, posterior splint, and elevation while awaiting surgery. In the study group, the patients had a foot pump
applied to the foot with a posterior splint and elevation while awaiting surgery.
Main Outcome Measurements:
The volumetric change of the foot at twenty-four-hour intervals for up to seventy-two hours in both the control and study groups.
All thirteen patients tolerated the foot pump
. The differences in the volume between Day 1 (baseline) and Day 2 for the foot pump
and control groups were minus forty and plus seventy-six milliliters, respectively (p
= 0.02). Between Days 1 and 3, the differences were minus ninety-six milliliters for the foot pump
group and plus thirty-seven milliliters for the control group (p
A significant progressive decrease in the foot volume was noted during the first forty-eight hours after application of the foot pump
in patients with excessive edema
precluding operative fixation of a calcaneus fracture
upon presentation. The pump was well tolerated by all the patients in the study group. Thus, we believe the pump serves as a useful adjunct in the preoperative edema
resolution following these complicated fractures.