Tourniquets May Increase Postoperative Swelling and Pain after Internal Fixation of Ankle Fractures

Evaluation of pain in bilateral total knee replacement with and without tourniquet; a prospective randomized control trial

“…Patients undergoing lower limb surgery without tourniquet use shown less postoperative pain. 9,19,20 Lower tourniquet cuff pressures have also been suggested to decrease postoperative pain. 21,22 When a standard cuff pressure (350 mm Hg) was compared with 100 mm Hg plus systolic blood pressure (mean cuff pressure 230 mm Hg) the results showed significantly less postoperative thigh pain during the first three days of the lower pressure.…”

Clinical use of a new tourniquet system for foot and ankle surgery

“…The effect of tourniquet use in foot and ankle surgery has been controversial [5,6,12]. Omeroglu et al [12] reported a relationship between the use of tourniquet and the intensity of postoperative pain in surgically treated malleolar fractures.…”

“…They did not recommend using a tourniquet in the operative treatment of simple, isolated fibular fractures. Furthermore, recently, Konrad et al [5] recommended not using a tourniquet for osteosynthesis of ankle fractures, following a comparison of the clinical results (postoperative swelling and pain, ankle range of motion) with (26 cases) and without (28 cases) a thigh tourniquet. Nevertheless, a pneumatic tourniquet is commonly used in foot and ankle surgery according to the recent survey of tourniquet use in orthopaedic foot and ankle surgeons [15,17] to provide a clean, dry operative field, which improves visualisation of anatomical structures and reduce operation time.…”

“…Although some studies have shown advantages in not using a tourniquet in foot and ankle surgery [5,6,12], it seems likely that, for reasons of convenience and long-established practice, the general use of tourniquets will continue. Although the incidence of complications of tourniquet use is very rare (5 complications in 3,027 operations on the foot and/or ankle in a report from the United States [1]), surgeons should choose a more practical tourniquet such as this in foot and ankle surgery.…”

“…The use of tourniquet in foot and ankle surgery has been controversial [5,6,12]. Advantages have been noted in terms of postoperative pain, swelling, rehabilitation, etc.…”