Screening for Posttraumatic Lower Extremity Lymphedema: Patient Characteristics, Risk Factors, and Quality of Life Outcomes

Lower extremity lymphedema (LEL) is a frequent, under-recognized, and chronic condition. The prevalence of this condition in patients with lower limb trauma is unclear. A self-reported lower extremity lymphedema screening questionnaire (LELSQ) was recently validated for screening LEL. The primary aim of this study was to investigate the clinical and demographic characteristics of posttraumatic LEL (PTLEL) in patients with a history of severe lower extremity trauma using the LELSQ. Secondary objectives were to identify risk factors for PTLEL, to investigate the relationship between LELSQ scores, health-related quality of life (HR-QoL), and lower extremity functioning.Patients treated for complex lower extremity trauma between January 1, 2009, and December 31, 2019, in two level one trauma centers who meet inclusion criteria were sent three questionnaires: LELSQ, Eq. 5D-5L, and the Lower Extremity Functional Scale (LEFS). Additionally, baseline demographic and trauma data were collected.A total of 115 patients (46.0%) responded, of which 95 were included. LELSQ screened 59 patients (62.1%) positive for PTLEL. 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 with non-PTLEL (90.0 and 0.874, respectively). A clinically reported difference was found in the LEFS median scores, with PTLEL 39.0 compared with 66.0 in non-PTLEL.Among patients who participated in this study, 62.1% screened positive for PTLEL following complex lower limb trauma. PTLEL patients reported reduced HR-QoL and lower extremity functioning compared with non-PTLEL patients, indicating that this is a frequent and important issue following lower limb trauma.