International Journal of Orthopaedics Sciences

Effect of tourniquet on skeletal muscle ischaemia and return of function: A prospective randomized clinical study

2021, Volume 7 Issue 3

Effect of tourniquet on skeletal muscle ischaemia and return of function: A prospective randomized clinical study

Author(s): Dr. Rahul Yadav, Dr. Deepak Rai, Dr. Ajit Singh and Dr. Arul kumar Nallakumarasamy
Abstract: Objectives: The purpose of this prospective randomized trial was to examine the effect of tourniquet use on skeletal muscle damage and return of function after closed tibial interlocking nail. Methodology: 74 patients who underwent closed tibial nailing were randomly allocated to the use of an inflated pneumatic tourniquet (group 1, n =37) or no tourniquet (group 2, n =37). Patients with Compound tibia fractures; Compartment syndrome; Multiple fractures; Polytrauma and infection were excluded. The primary outcome measures were pain, measured with a visual analog scale (VAS), return of activity measured by ability to do SLR(Straight Leg Raising) postoperatively and serum creatine phosphokinase (CPK) levels monitored preoperatively and 24 hours postoperatively. Results: The 2 groups did not differ in baseline demographics. Mean duration of surgery was similar in both groups. There was threefold increase in mean CPK in group1when the duration of surgery is < 90 minutes and fivefold increase when duration exceeded 90 minutes, but only 2 times increase of CPK in group2 which was not affected by the duration of surgery. The difference in the mean scores between the two groups was statistically significant from 2nd to 4th postoperative day (P-value < 0.05). The mean days to regain SLR in patients with duration of surgery more than 90 minutes were significantly higher than that of mean scores in patients with duration of surgery less than 90 min in group1 only. Conclusions: It is much safer not to use tourniquet where surgery is going to be prolonged than 90 minutes. Early postoperative pain is lesser and return of function is faster in patients who were operated without a tourniquet as compared to patients with prolonged surgery with tourniquet.
Pages: 242-245  |  689 Views  184 Downloads
How to cite this article:
Dr. Rahul Yadav, Dr. Deepak Rai, Dr. Ajit Singh, Dr. Arul kumar Nallakumarasamy. Effect of tourniquet on skeletal muscle ischaemia and return of function: A prospective randomized clinical study. Int J Orthop Sci 2021;7(3):242-245. DOI: 10.22271/ortho.2021.v7.i3d.2754
 
International Journal of Orthopaedics Sciences
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