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Upper extremity edema control: rationale of the techniques.

Edema of the upper extremity is a condition frequently encountered by those interested in hand rehabilitation. It frequently accompanies other problems associated with functional restrictions of the upper extremities. Its control and prevention are a part of the total rehabilitation of these extremities. Persistent edema becomes painful, disfiguring, and disabling. Fibrosis develops in the edematous tissue leading to contractures. The susceptibility for infection increases and the functional ability of the limb decreases. Treatment is based upon an understanding of the pathophysiology of edema. Edema occurs when there is an imbalance of effective pressures across the capillary membrane or when there is an obstruction to venous and lymphatic flow. The conservative treatment program consists of elevation, massage, use of external compression devices, exercises, and instructions to avoid contributing factors. This paper will discuss the physiologic rationale for the effectiveness of these treatment methods.