title: Vascular Impulse Technology versus elevation in the treatment of posttraumatic swelling of extremity fractures: study protocol for a randomized controlled trial.
abstract: Fractures of the extremities are often complicated by a variable degree of swelling secondary to hemorrhage and soft tissue injury. Patients typically require up to 7 days of inpatient bed rest and elevation to reduce swelling to an acceptable level for operative treatment with internal fixation. Alternatively, an intermittent pneumatic compression device, such as the Vascular Impulse Technology (VIT) system, can be used at the injured extremity to reduce the posttraumatic swelling. The VIT system consists of a pneumatic compressor that intermittently rapidly inflates a bladder positioned under the arch of the hand or the foot, which results in compression of the venous hand or foot plexus. That intermittent compression induces an increased venous velocity and aims to reduce the soft tissue swelling of the affected extremity.
  
  
  
  The VIT study is a prospective, monocenter, randomized controlled trial to compare the VIT system with elevation in the treatment of posttraumatic swelling in the case of a fracture of the upper and lower extremity. This study will include 280 patients with fractures of the upper and the lower extremity with nine different injury types. For each of the nine injury types a separate randomization to the two intervention groups (VIT group or control group) will be performed. The primary outcome parameter is the time taken for the swelling to resolve sufficiently to permit surgery. A separate analysis for each of the nine injury types will be performed.
  
  
  
  In the proposed study, the effectiveness of the VIT system in the treatment of posttraumatic swelling of upper and lower extremity fractures will be evaluated.
  
  
  
  German Clinical Trial Register, No. DRKS00010510 . Registered on 17 July 2016.
authors.affiliation: Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwigshafen am Rhein, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Schnetzke
authors.affiliation: Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwigshafen am Rhein, Germany.
authors.forename: Benedict
authors.initials: B
authors.lastname: Swartman
authors.affiliation: Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwigshafen am Rhein, Germany.
authors.forename: Isabel
authors.initials: I
authors.lastname: Bonnen
authors.affiliation: Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwigshafen am Rhein, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Keil
authors.affiliation: Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Schüler
authors.affiliation: Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwigshafen am Rhein, Germany.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Grützner
authors.affiliation: Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen at Heidelberg University Hospital, Ludwigshafen am Rhein, Germany. Jochen.Franke@bgu-ludwigshafen.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Franke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D002985:Clinical Protocols; D004487:Edema / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005121:Extremities / Q000098:blood supply*; D005260:Female; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000150:complications* / Q000175:diagnosis; D005858:Germany; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011446:Prospective Studies; D012039:Regional Blood Flow; D012107:Research Design; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cryotherapy; Elevation; Intermittent pneumatic compression; Lower extremity; Posttraumatic swelling; Upper extremity; Vascular impulse