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Tourniquet Use Does Not Affect Soft Tissue Outcomes Following Rotational Ankle Fracture Repair.

Justin F Xie1, Abhishek Ganta1,2, Nirmal Tejwani1

  • 1Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, New York, New York.

Foot & Ankle Specialist
|July 4, 2026
PubMed
Summary

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Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Tourniquet use in ankle fracture surgery did not increase complications like infection or nerve injury. This study supports its safe use when surgeons carefully select patients for the procedure.

Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Surgical Complications

Background:

  • Tourniquet use in ankle fracture fixation is debated due to soft tissue complication concerns.
  • Previous studies show increased short-term pain, but other complication associations are under-investigated.

Purpose of the Study:

  • To investigate the association between tourniquet use and postoperative complications in ankle fracture fixation.
  • To evaluate wound complications, infections, nerve injuries, and bony union rates.

Main Methods:

  • Retrospective cohort study of 617 adult patients undergoing ankle fracture fixation (OTA Type 44).
  • Patients stratified by tourniquet use (446 vs. 171).
  • Multivariable logistic regression analyzed the association between tourniquet use and outcomes.
Keywords:
ankle injuriesfracturesgeneral disordersheel-rearfoot-anklesports injuriessports podiatrysprainsstrainssurgical complicationstrauma

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Main Results:

  • Tourniquet use was not associated with increased odds of wound complications, infection, delayed healing, or nerve injury.
  • Tourniquet use correlated with decreased estimated blood loss but not increased operative time.
  • While rare, venous thromboembolism and nonunion occurred in the tourniquet group, not the non-tourniquet group.

Conclusions:

  • Tourniquet use in closed rotational ankle fracture fixation is not linked to higher soft tissue or bony complications.
  • Findings support surgeon preference for tourniquet use with appropriate patient selection.
  • The practice appears safe for ankle fracture fixation surgery.