Tourniquet use during plating of acute extra-articular tibial fractures: effects on final results of the operation

Abstract

Background: Tourniquet use in orthopedics is practiced for the sake of the surgeon's comfort with a bloodless field, though it is associated with potential risks. This study was performed to assess the effects of using or avoiding a tourniquet when plating acute extra-articular tibial fractures.

Patients and methods: One hundred thirty-eight patients with acute extra-articular tibial fractures were randomized into two groups: "tourniquet" and "without tourniquet". Postoperative pain, amount of hemovacuum drainage, and duration (time to complete bone union and nonunion, and development of infection) were assessed.

Results: At the end of the study, all 138 patients had been followed up for at least 1 year. The difference between the two groups was statistically significant with regard to duration of surgery, amount of hemovacuum drainage, and postoperative pain. The patients in without tourniquet group perceived less pain (p = 0.007), and their hemovacuum drainage was lesser than that of the tourniquet group (p = 0.03), though the average duration of the operation was longer (p = 0.001).

Conclusion: Avoidance of tourniquet use does not decrease the time to union or nonunion or the infection rate after plating of tibial fractures, but it is associated with a decrease in the patient's pain perception in the postoperative period.