RESUMO
Over a two-year period, 265 Norwegian orthopaedic surgeons working at 71 institutions performed 63,484 operations under a tourniquet. Their replies to a questionnaire revealed that they mostly followed modern guidelines in their use of the tourniquet. Most felt that the tourniquet could be left on for two hours, and that it could be re-applied after 15 minutes. A total of 26 complications (one in 2442 operations) that might have been due to the tourniquet were reported, of which 15 were neurological. Three were in the upper limb (one in 6155 operations) and 12 in the lower limb (one in 3752 operations). Two were permanent (one in 31,742 operations), but the remainder resolved within six months. One permanent and one transient complication occurred after tourniquet times of three hours. The incidence of tourniquet complications is still at least as high as that estimated in the 1970s.
Assuntos
Procedimentos Ortopédicos/instrumentação , Torniquetes/estatística & dados numéricos , Braço/inervação , Braço/fisiopatologia , Pressão Sanguínea/fisiologia , Criança , Humanos , Perna (Membro)/inervação , Perna (Membro)/fisiologia , Perna (Membro)/fisiopatologia , Noruega , Doenças do Sistema Nervoso Periférico/etiologia , Complicações Pós-Operatórias , Pressão , Fatores de Tempo , Torniquetes/efeitos adversosRESUMO
Our aim was to determine if a tourniquet placed on the forearm has any advantage in clinical practice over the usual position on the upper arm. We randomised 50 patients who were undergoing an open operation for carpal tunnel syndrome under local anaesthesia into two groups. One had a tourniquet on the upper arm and the other on the forearm. The blood pressure, pulse, and level of pain were recorded at intervals of five minutes during the operation. The surgeons were also asked to evaluate the quality of the anaesthesia, the bloodless field, and the site of the tourniquet. The patients tolerated the tourniquet on the upper arm and forearm equally well. The surgeons had some difficulties when it was placed on the forearm. We therefore recommend placement of a tourniquet on the upper arm for operations on the hand and wrist which are carried out under local anaesthesia.
Assuntos
Síndrome do Túnel Carpal/cirurgia , Torniquetes , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Feminino , Antebraço , Humanos , Masculino , Pessoa de Meia-Idade , Medição da DorRESUMO
We operated on 9 patients for distal biceps tendon rupture using the Boyd-Anderson technique. All patients were re-examined after at least 1 year using a questionnaire, radiographs, motion measurements and isokinetic testing. 2 patients had temporary radial nerve dysfunction and 7 patients had diminished forearm rotation. Elbow flexion strength was reduced by median 13% and supination strength by 19%. We think the Boyd-Anderson technique can be recommended, but slightly reduced strength and forearm rotation must be expected.
