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Tourniquet paralysis in microsurgery

A Landi1, A Saracino, M Pinelli

  • 1Microvascular Unit, University of Modena, Italy.

Annals of the Academy of Medicine, Singapore
|July 1, 1995
PubMed
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Tourniquet paralysis, a surgical complication, affects upper limb nerves, with higher incidence in microsurgery. Most patients recover fully within months, but caution is advised for certain patient groups.

Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Microsurgery

Background:

  • Tourniquet paralysis is a significant post-operative complication.
  • This study reviews 15 cases of tourniquet paralysis from 1972-1992.
  • Cases were divided into routine upper limb operations and microsurgical procedures.

Purpose of the Study:

  • To analyze the incidence and outcomes of tourniquet paralysis.
  • To identify risk factors and patient populations requiring caution.
  • To evaluate recovery patterns following tourniquet application.

Main Methods:

  • Retrospective case review of 15 patients.
  • Analysis of surgical procedures, nerve involvement, and recovery times.
  • Comparison of complication rates between routine and microsurgical procedures.

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Main Results:

  • Incidence of tourniquet paralysis was 1:7000 for routine and 1:4300 for microsurgery.
  • Median, radial, and ulnar nerves were commonly affected, with radial nerve most severely impacted.
  • Average recovery took 105-115 days; only one patient had incomplete recovery.

Conclusions:

  • Tourniquet use requires careful consideration of patient-specific risk factors.
  • Contraindications include congenital nerve compression susceptibility, coagulation disorders, neuropathies, and specific systemic conditions.
  • Limit tourniquet use in microvascular procedures to the initial replantation phase.