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J Reconstr Microsurg
DOI: 10.1055/a-2803-4526
Original Article

Screening for post-traumatic lower extremity lymphedema: Patient characteristics, risk factors, and quality of life outcomes.

Authors

  • Chelsea A Allen-Brough

    1   Department of Plastic and Reconstructive Surgery, Waikato Hospital, Hamilton, New Zealand (Ringgold ID: RIN3718)

  • Brett Hahn 

    2   Department of Plastic and Reconstructive Surgery, University Medical Centre Utrecht, Utrecht, Netherlands (Ringgold ID: RIN8124)

  • Patrick Romijn

    3   Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, Netherlands (Ringgold ID: RIN6034)

  • Stefan Hummelink 

    3   Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, Netherlands (Ringgold ID: RIN6034)

  • Arne C Berger

    4   Department of Orthopedic Surgery, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands (Ringgold ID: RIN7898)

  • Pim van Egmond

    4   Department of Orthopedic Surgery, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands (Ringgold ID: RIN7898)

  • Dietmar J.O. Ulrich

    3   Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, Netherlands (Ringgold ID: RIN6034)

  • Tim De Jong

    3   Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, Netherlands (Ringgold ID: RIN6034)
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Background: 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 post-traumatic 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, and lower extremity functioning. Methods: Patients treated for complex lower extremity trauma between January 1st 2009, and December 31st 2019, in two level one trauma centres who meet inclusion criteria were sent three questionnaires: LELSQ, EQ5D-5L, and the Lower Extremity Functional Scale (LEFS). Additionally baseline demographic and trauma data were collected. Results: 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 to non-PTLEL (90.0 and 0.874, respectively). A clinically reported difference was found in the LEFS median scores, with PTLEL 39.0 compared to 66.0 in non-PTLEL. Conclusion: Among patients who participated in this study, 62.1% screened positive for PTLEL following complex lower limb trauma. PTLEL patients reported reduced health-related quality of life and lower extremity functioning compared with non-PTLEL patients, indicating that this a frequent and important issue following lower limb trauma.



Publication History

Received: 20 January 2025

Accepted after revision: 27 July 2025

Accepted Manuscript online:
04 February 2026

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