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| The King Henry VIII |
Venous ulcers affect the quality of life of people. Chronic venous disease can be painful, irritating and may also change the psychology of a person.
In case of Henry VIII it was said so! Subsequent ulceration affected Henry's legs bilaterally below the knee
and may have been due to venous disease. The wearing of a garter
and the references to the King's shapely calf make it unlikely that
Henry had prominent primary varicose veins. However, he may have
acquired venous hypertension as a result of deep vein thrombosis (DVT).
History does not record how tightly the garter was bound around his
upper calf and he had several injuries to his legs as a result of his
sporting activities, both of which represent risk factors for DVT. The
most severe injuries were sustained during the fall from his horse that
rendered him unconscious and crushed his legs in 1536. Crush injury with
or without associated fracture of one or more long bones with obesity
and relative immobility would increase the risk of DVT, damage to the deep venous system and subsequent venous insufficiency.
Severe venous hypertension may therefore have resulted in ulceration.
An untreated compound fracture may also result in diffuse infection with
cellulitis, osteomyelitis, deep abscess formation and a persistently
discharging sinus.
A compound fracture may well have rendered Henry unable to walk and
such a suggestion is absent in the records of the time. It is therefore
much more likely that Henry suffered an extensive DVT as a result of his
injuries and subsequent immobility resulting in the classical pattern
of venous ulceration. J R Soc Med. 2009 December 1; 102(12): 514–517.
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