Surgical Treatment of Malleolar Fracture with or without Use of a Tourniquet

Kang, Soo Yong; Lee, Eun Woo; Kang, Ki Ser; Lee, Jae Sung

Abstract

PURPOSE
To determine the advantage and disadvantage of using tourniquet in the malleolar fracture treated with open reduction and internal fixation. MATERIAL AND METHOD: Randomized 12 patients were operated on with use of a tourniquet (Group T), and 12 patients without use of a tourniquet (Group NT). The operation time, the technical difficulty during operation, the incidence of postoperative complication and the intensity of postoperative pain were compared between the two groups. RESULT: The demographic of the two groups, including age, sex, fractire type, and delay after injury were similar. The average duration of the operation and the technical difficulty during operation were similar between the both group (76min. in Group T, 81min in Group NT, p=0.28) There were no severe complications, however, Four patients had local redness and oozing (3 in group T, 1 in group NT). The patients in group T had higher VAS (Visual Analogue Scale, p=0.014) and more frequencies of analgesic injection (p=0.03) than within 24 hours after operation than those in Group NT, which difference was more significant in male patients and the patient of more than 40-year old.
CONCLUSION
Open reduction and internal fixation of the malleolar fracture without use of a tourniquet can be performed with little difficulty and the severity of postoperative pain and the incidence of postoperative complication can be reduced.