A study of leg edema in immobile patients.
BACKGROUND
Our objectives were to elucidate the pathophysiology of leg edema in immobile patients and to discuss reasonable management of this condition.


RESULTS
The 30 patients with leg edema had visited our clinic between April 2009 and March 2013; they suffered from severe gait disturbance, had no significant venous abnormalities detected using duplex ultrasound, and did not have any systemic diseases that could cause leg edema. Here, we review their symptoms, examinations, and treatments. Among 59 edematous legs of the 30 patients, 30 legs (51%) had symptoms that indicated advanced chronic venous insufficiency. The ankle range of motion and calf : ankle circumference ratio were abnormal in only 3 (5%) and 10 (17%) of the legs, respectively. The severity of edema and subcutaneous inflammation, which was confirmed using ultrasonography, was significantly influenced by gravity. Air plethysmography and lymphangioscintigraphy were completed in 15 and 10 patients, respectively, neither of which revealed any significant abnormalities. Reasonable success for all patients was achieved by compression therapy and physical therapy without medications.


CONCLUSIONS
It was assumed that leg edema in these immobile patients was mainly caused by venous stasis because of the immobility itself, not because of anatomical problems. The patients were successfully managed by compression and physical therapy alone.
Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine.
Kotaro
K
Suehiro
Noriyasu
N
Morikage
Masanori
M
Murakami
Osamu
O
Yamashita
Koshiro
K
Ueda
Makoto
M
Samura
Kimikazu
K
Hamano
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004487:Edema / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D007866:Leg / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014689:Venous Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy