Is the swelling of the limb after the fracture not a result of a bad surgery? The swelling of the limb is not a result of a poorly performed surgery, but is related to the surgery, the fracture itself, including the anesthesia. Why does this happen? Because after the trauma, the patient did not go down 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 bandages as tight as possible? If the elastic bandage is too tight, the pressure on the limb exceeds the pressure of the artery, which is dangerous and can lead to necrosis of the distal part of the 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 that this type of patient cannot use elevation of the affected limb to reduce swelling? If a patient has an uncomfortable swollen limb, elevating the limb will certainly help the swelling to subside. If the limb is placed in a downward position, the pressure in this area is the highest. If it is elevated, the local venous pressure is reduced, which is conducive to venous reflux in 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 office, so they elevate their legs a little bit to help the swelling go down and make them more comfortable. Does elevating the affected limb to reduce swelling have any effect on the fracture of the femoral neck? When a fracture of the femoral neck is treated with internal fixation, the movement of straightening and raising the leg should never be done. How many times more force is applied to the hip joint than to the leg when the leg is straightened and lifted? If a person weighs 70 kg, the weight of one thigh is about 1/5 of the weight, which is about 14 kg. And in the straightening of the leg when the hip joint to bear the force is 1.5 times the weight of the leg, 14 kg of 1.5 times is about 21 kg, which 21 kg of force how big? Let’s think about the water fountain with a bucket is 10 liters, 10 kg, that is, two buckets so heavy. We use three nails to fix the weight of two buckets of water, is very, very difficult, so this action is very dangerous. How much force can these three nails actually withstand? If a patient with a femoral neck fracture does horizontal flexion and extension in the lateral position, this force is not a problem, because the horizontal flexion and extension joint can withstand a force of 3-5 kg, and the difference between 3-5 kg and 21 kg is very big. Therefore, the action of straightening and lifting the leg is an absolute contraindication to activity for patients receiving internal fixation treatment for femoral neck fractures. When swelling occurs in the affected limb, can active massage or hot compresses be used to activate the blood? Local massage is definitely beneficial 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.