Sixty-eight patients with a complex extremity joint fracture were randomized to receive intermittent pneumatic compression using a vascular impulse technology (VIT) device before and after surgery (n=35) or elevation (n=31). The primary outcome of interest was the time from hospital admission to operability. Secondary outcomes of interest included length of stay, decongestion (%/day), the proportion of pain-free patients, complications, and revision. VIT therapy did not provide any significant improvement in overall time to operability (p=0.12), however it significantly reduced the time to operability in lower extremity fracture patients (p=0.009). No differences in length of stay were observed. Decongestion rate trended in favour of the VIT group (p=0.05), and the proportion of pain-free patients before and after surgery was significantly higher in the VIT group (p=0.044; p<0.001, respectively).