The Journal of Bone and Joint Surgery, Vol 75, Issue 5 700-703, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
Use of a tourniquet in the internal fixation of fractures of the distal part of the fibula. A prospective, randomized trial
N Maffulli, V Testa and G Capasso
First Institute of Orthopaedics, University of Naples, First Medical School, Italy.
A prospective, randomized trial was undertaken to determine the rate of
complications after the use of a tourniquet during open reduction and
internal fixation of simple, closed fractures of the distal part of the
fibula. Forty patients were operated on with use of a tourniquet (Group 1)
and forty patients, without use of a tourniquet (Group 2). The average
duration of the operation was significantly different between the two
groups (41 +/- 9 minutes for Group 1 compared with 53 +/- 12 minutes for
Group 2 [p = 0.026]). There were more complications in the patients in
Group 1, two of whom had an isolated deep-vein thrombosis of the calf. The
wound was possibly infected in eleven patients (seven in Group 1 and four
in Group 2 [p < 0.05]) and frankly infected in three patients, all in
Group 1 (p < 0.05). The plaster-of-Paris cast needed to be changed in
three patients from Group 1. The patients in Group 1 returned to work an
average of one week later than those in Group 2. The mean duration of
follow-up was eighteen months (range, nine to thirty-two months). Given the
lower prevalence of postoperative complications and the shorter time to
recovery for the patients in Group 2, we believe that it is justified not
to use a tourniquet in the operative treatment of simple, isolated fibular
fractures.
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