Effective modality to enhance fracture and soft-tissue healing

Below is a great study which speaks to the benefits of IPC (Intermittent pneumatic compression)…along with some more info on the new NormaTec 2.0.

Intermittent Pneumatic Compression in Fracture and Soft-Tissue Injuries Healing

Anil Khanna, Nikolaos Gougoulias, and Nicola Maffulli

Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Thornburrow Drive, Hartshill, Stoke-on-Trent, ST4 7QB Staffs, UK


Current methods of fracture care use various adjuncts to try and decrease time to fracture union, improve fracture union rates and enhance functional recovery. Intermittent pneumatic compression (IPC), one such modality, is used in the management of both fractures and soft-tissue injuries.

Methods and results:

A search of PubMed, Medline, CINAHL, DH data and Embase databases was performed using the following keywords ‘intermittent pneumatic compression,’ ‘fracture healing’ and ‘soft tissue healing.’ Sixteen studies on the use of IPC in fracture and soft-tissue healing were identified. These studies demonstrated that IPC facilitates both fracture and soft-tissue healing with rapid functional recovery.


IPC appears to be an effective modality to enhance fracture and soft-tissue healing. However, the number of subjects in human studies is small, and adequately powered randomized controlled trials in humans are required to produce stronger, clinically-relevant evidence.


Modern fracture care aims to achieve union and to restore function as soon as possible. This has led to the introduction of several treatment modalities to enhance healing and expedite recovery. Intermittent pneumatic compression (IPC) is one of them. The concept of IPC has been experimented with since the 19thcentury, when physicians tried to improve circulation by exerting external pressure on the legs. Cyclic positive and negative pressure improved arterial circulation in patients with arteriosclerosis and tromboangitis obliterans. IPC is used mainly to prevent deep vein thrombosis, but its potential role in fracture and soft-tissue healing has also been investigated. IPC has the potential of enhancing the fracture and soft-tissue healing process with early return to functional activities. This review explores the rationale of use of IPC, and investigates the role of IPC in fracture and soft-tissue healing.

Improvement in vascularity

When compression is applied, the sudden pressure gradient at the compression zone accelerates the blood forward with subsequent collapse of the lumen of the vessel at the compression zone, effectively facilitating venous return. The accelerated blood moves forward as a pulsatile volume that causes distension of the compliant lumen. If the pressure is applied sequentially, the accelerated blood flow could increase the peak flow velocity by over 200% within the lumen. The higher flow velocity increases the shear stress on the endothelial cells lining the lumen, which may also facilitate clearance of the valve sinuses. The improved emptying of lower extremity veins and lowered venous pressure lead to an increase in arterio-venous pressure gradient and decreased peripheral resistance. This increased disparity of pressure induces an increase in lower extremity arterial blood flow. This increase in blood flow not only improves cutaneous circulation but also increases the vascularity of bone and soft-tissues. The increased blood flow to the bone is likely to improve blood-flow to the fracture site, thereby increasing the supply of essential elements such as growth factors, proteins, oxygen and other components necessary for fracture repair. This finding has been supported by the formation of abundant callus at the fracture site, increased bone mineral density and bone mineral content following IPC treatment.

Among the modalities available to enhance fracture and soft-tissue healing, IPC seems to be safe and effective. Although IPC has been used in several human and animal studies, more human trials are needed to improve the strength of evidence. With the concept of ‘time is money’ being evident into every aspect of human life, a race towards enhanced fracture management is inevitable.

For more info: https://academic.oup.com/bmb/article/88/1/147/267433




Patented NormaTec Pulse compression:

  • Pulsing – dynamic compression mobilizes fluid
  • Gradient Hold – prevents fluid backflow
  • Distal Release – allows normal circulation

External pneumatic compression has also been shown to increase flexibility and reduce select skeletal muscle oxidative stress and proteolysis markers during recovery from heavy resistance exercise.

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