Upper extremity tourniquet effects in carpal tunnel release

Area of Science:

• Orthopedics
• Neurology
• Surgical Research

Background:

• Carpal tunnel release is a common surgical procedure.
• The use of tourniquets in upper extremity surgery is standard practice.
• Potential neurological complications following tourniquet application require investigation.

Purpose of the Study:

• To investigate the presence and extent of upper extremity denervation after carpal tunnel release.
• To compare the effects of tourniquet application versus no tourniquet on postoperative muscle denervation.

Main Methods:

• Electromyography (EMG) was used to examine cervical paraspinal and upper extremity muscles.
• Sixty patients undergoing carpal tunnel release were randomized into two groups: with tourniquet (31) and without tourniquet (29).
• EMG assessments were performed 3 weeks before and 3 weeks after the surgical procedure.

Main Results:

• Postoperatively, 77% of patients in the tourniquet group exhibited denervation in non-thenar upper extremity muscles.
• Only one patient in the control (no tourniquet) group showed similar electromyographic abnormalities.
• Tourniquet application, time, and pressure were not significantly correlated with postoperative forearm denervation.

Conclusions:

• Upper extremity tourniquet application during carpal tunnel release surgery is associated with subclinical, temporary muscle denervation.
• The observed changes are likely due to nerve alterations and denervation, suggesting a need for careful tourniquet management.