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Limb swelling after bone plate fixation is a common phenomenon in the treatment of fractures, mainly caused by surgical trauma, local circulatory disorders and inflammatory responses. If not handled properly, it may lead to delayed wound healing, increased risk of infection and hindered recovery of joint function. The following are the targeted handling measures:
Elevate the affected limb
Elevate the affected limb above the level of the heart (such as by using a pillow or stent), and utilize gravity to promote venous and lymphatic return, reducing blood accumulation at the distal end of the limb.
It is recommended to keep it elevated continuously, especially when resting or sleeping at night, to avoid prolonged drooping that may aggravate swelling.
2. Local compression bandaging
Use an elastic bandage to spiral the limb from the distal end to the proximal end. The pressure should be uniform and moderate to avoid being too tight and affecting blood circulation or too loose and ineffective.
The bandaging area should cover the swollen area, but the temperature, color and sensation of the distal skin should be checked regularly to prevent pressure injury.
3. Reasonable application of cold and hot compresses
Cold compress: In the early postoperative period (within 48 hours), use ice packs or cold compress patches for 15 to 20 minutes each time, 3 to 4 times a day. This can contight blood vessels, reduce exudation and relieve pain.
Hot compress: Switch to hot compress 48 hours after the operation to promote blood circulation and the absorption of inflammation. The temperature should be controlled at 40-45℃ to avoid scalding.
4. Active and passive movements
Active movement: Encourage patients to perform active activities of unfixed joints (such as finger flexion and extension, ankle pump movement) to promote muscle contraction and venous return.
Passive movement: Under the guidance of a rehabilitation therapist, perform gentle passive movements on the fixed joint to prevent joint stiffness and deep vein thrombosis.
5. Drug treatment
Non-steroidal anti-inflammatory drugs, such as ibuprofen, can alleviate inflammatory responses and pain, but attention should be paid to gastrointestinal and cardiovascular side effects.
Dehydrating agents: Under the guidance of a doctor, short-term use of mannitol and others can rapidly reduce tissue edema, but electrolyte and renal function need to be monitored.
6. Physical factor therapy
Pneumatic therapy: By periodically inflating and compressing the limbs, it promotes lymphatic return and is suitable for early postoperative swelling.
Ultrasound and laser: Ultrasound can soften scar tissue, while laser can improve local microcirculation and accelerate the resolution of swelling.
7. Adjustments to diet and lifestyle
Low-salt diet: Reduce sodium intake, lower water and sodium retention in the body, and relieve swelling.
Quit smoking and limit alcohol intake: Both nicotine and alcohol in tobacco can affect vascular function and delay the resolution of swelling.
Precautions
Closely monitor the degree of swelling and skin changes. If tension blisters, cyanosis of the skin or abnormal sensations occur, seek medical attention immediately.
Avoid excessive activity or weight-bearing of the affected limb to prevent fracture displacement or loosening of internal fixation.
Regular follow-up examinations should be conducted to assess the reduction of swelling and the progress of fracture healing, and the treatment plan should be adjusted in a timely manner.