Is the swelling of the limb after the fracture not a good surgery? Dr. Chen Hua: The swelling of the limb is not a result of poor surgery, but is related to the surgery, the fracture itself, including anesthesia. Why does this happen? Because after the trauma, the patient did not go to the ground without weight bearing, which often causes the limb to sag in the lowest position. For example, in the case of ankle fracture, when we stand up, the foot is in the lowest position of the body, and the venous pressure in this area is the highest. After the trauma and anesthesia, the local blood circulation, especially the sympathetic nervous system, which governs the blood vessels, is disturbed, and with the highest gravity, it causes poor local venous return and local stasis, which in turn leads to increased venous pressure and leakage of fluid from the vessels into the surrounding tissues, resulting in local swelling. It can occur frequently in severe patients, even six months to a year after surgery. With normal exercise, including walking and activity, this swelling can slowly subside after a period of time. How to solve the problem of swelling? The easiest way is to use an elastic bandage. For fractures like those in the lower extremities, you can start at the distal end of the limb, at the toe, and wrap it across the knee to effectively reduce the swelling of the limb. This is somewhat like vascular surgery for patients with varicose veins, where the use of elastic stockings is helpful. Is it better to use elastic bandage as tight as possible? Dr. Chen Hua: If the elastic bandage is too tight, the pressure on the limb will be dangerous if it exceeds the pressure of the artery, which will lead to necrosis of the distal limb. How much pressure is appropriate? In fact, a certain amount of pressure is sufficient, but not more than the arterial pressure, usually around 5 kg. It is contradictory to elevate the affected limb to reduce swelling, but then swell up again after the lower limb fracture sags. Is it true that this type of patient cannot use elevation of the affected limb to reduce swelling? Dr. Chen Hua: If a patient has an uncomfortable swollen limb, elevating the limb will definitely help the swelling go down. If the limb is placed in a downward position, the pressure in this area is the highest. If the limb is elevated, the local venous pressure is reduced, which is conducive to the venous return of the swollen limb, and the fluid in the tissue returns to the blood vessels, and the swelling will be reduced. Many patients who have fractures, such as ankle fractures, have to work in the unit, so they elevate their legs a little bit to help the swelling go down and get more comfortable. When swelling occurs in the affected limb, can active massage or hot compress be used to activate blood circulation? Dr. Chen Hua: Local massage is definitely good for the swelling to subside. What are the benefits of doing this? Cold water alternates with warm water, cold water stimulates capillary constriction, hot water stimulates capillary diastole, repeated contraction and diastole is conducive to the swelling of the limb, this way is better than soaking hot water.