Article

This case report describes a patient who developed
lower-extremity lymphedema secondary to orthopedic trauma and surgery and reports
the response to complete decongestive physical therapy (CDP), with 8 treatment
sessions over 3 months.
CASE DESCRIPTION: The patient was a 56-year-old man who
sustained a right ankle displaced fibular fracture, underwent open reduction
internal fixation surgery 12 days later, and developed lymphedema 4 months
postinjury. The patient's impairments of the right lower extremity included
increased girth, decreased ankle range of motion, and increased pain. Due to
these impairments and the inability to fit into normal footwear, the patient
limited activities such as ambulating long distances and climbing stairs. This
limited activity restricted him from participating in his normal lifestyle
activities such as walking his dog in the community and performing all necessary
work duties. OUTCOMES: Using the truncated cone formula to measure limb volume,
the limb volume of the right (involved) lower extremity decreased 368 mL as a
result of CDP. The percentage of difference in limb volume between the right and
left lower extremities at the initial examination was 9%, and it was reduced to
less than 1% at discharge. He was independent with his home program in order to
maintain the results of therapy. DISCUSSION: Physical therapist management of
secondary lymphedema due to orthopedic trauma and surgery of the lower extremity
was effective in decreasing circumferential girth measurements and decreasing
limb volume, thereby improving gait and allowing the patient to fit into his work
and leisure shoes. The patient reported improvement in his ability to perform all
work activities, and he returned to his prior level of participation in the
community.

Langue : ANGLAIS