Background: Lower extremity lymphedema (LEL) is a frequent, underrecognized and, chronic condition. The prevalence of this condition in lower limb trauma patients is unknown. A self-reported lower extremity lymphedema screening questionnaire (LELSQ) was recently validated to screen for LEL in the general Dutch population. The primary aim was to investigate the prevalence of post-traumatic LEL (PTLEL) in patients with a history of severe lower extremity trauma with the use of the LELSQ. Secondary goals were to identify risk factors for PTLEL and investigate the relation between LELSQ scores and health related quality of life and lower extremity functioning.
Methods: Patients treated for complex lower extremity trauma between January 1st 2009 and December 31st 2019 at the Radboudumc and Tilburg Hospital who meet inclusion criteria, were sent three questionnaires: LELSQ, EQ5D-5L, and the lower extremity functional scale (LEFS). We also collected baseline demographic and trauma characteristic data.
Results: A total of 115 patients (46.0%) responded, 97 were included. LELSQ screened 59 (60.8%) positive for PTLEL. 33 (55.9%) PTLEL patients were familiar with having LEL before study participation, with 11 (33.3%) having received treatment. Those with PTLEL reported more problems with daily life with a lower median EQ-VAS and EQ-index score (70.0 and 0.700 respectively) compared to non PTLEL (0.874 and 90.0 respectively). A clinically reported difference was found with the LEFS median scores with PTLEL 39.0 compared to 66.0 in non-PTLEL.
Conclusion: Our study found a PTLEL prevalence of 60.8% in patients post complex lower limb trauma. PTLEL patients reported both reduced health-related quality of life and lower extremity functioning compared with non-PTLEL patients. Showing that this a frequent and significant issue for patients who have suffered lower limb trauma. Indicating the importance of screening patients to allow treatment, with the aim to reduce patient suffering.