Intermittent pneumatic pedal compression and edema resolution after acute ankle fracture: a prospective, randomized study.

Thirty patients with an acute Weber B or C ankle fracture were enrolled after signing an informed consent. Fifteen patients were randomized to a control group where they received a posterior splint, ice, and elevation before surgery. Fifteen patients were randomized to a pneumatic pedal compression group where they received the same treatment plus a pneumatic pedal compression device which was used full-time before surgery. Baseline volumetric measurements of the injured foot were obtained, followed by measurements at 24-hour increments until surgery. On average, the patients in the pneumatic pedal compression group had an 88 mL decrease in volume in the first 24 hours versus a 33 mL increase in the control group (P < 0.03) and a 31 mL decrease in the first 48 hours of treatment versus a 32 mL increase for the control group (P < 0.05). The pneumatic pedal compression was well tolerated by the majority of patients (only one did not tolerate its use because of pain) and, we believe, serves as a useful adjunct in preoperative edema resolution after ankle fracture.