Analysis of curative effect of low position tourniquet in calcaneal fracture surgery

Abstract This study was designed to investigate the role and curative effect of low position tourniquet in calcaneal fracture surgery. We studied a total of 42 calcaneal fracture patients who underwent reduction and internal fixation with plate via L-shaped approach with low position tourniquets using a retrospective analysis between January 2018 and July 2020. The fractures were all unilateral and fresh, and they were classified Sanders III and IV. All patients, with mean age of 47.2 years, had no medical complications. Two groups were categorized based on the position of tourniquets during surgery. Tourniquets were put on proximal thighs in one group (high position tourniquet group n=22), and above ankles in another (low position tourniquet group n=20). Observation index were as follows: operation time, tourniquet time, intraoperative bleeding and incision healing, postoperative fracture healing, ankle-hindfoot scoring system (AOFAS score) and visual analogue scale (VAS score), tourniquet complications such as soft tissue injury and deep venous thrombosis (DVT). No significant differences in general condition, fracture type and complications of the two groups before surgery were noted between the two groups (P>0.05). The low position tourniquet group had significantly less foot pain within two weeks after surgery and higher AOFAS scores of motion pain within 4 weeks after surgery than the high position tourniquet group (P<0.05). However, there was no significant difference in AOFAS function scores twelve weeks after surgery between the two groups (P>0.05). In addition, there were one case of DVT and two cases of soft tissue injuries in the high position tourniquet group, while no related complications were found in the low position tourniquet group (P<0.05). The use of low position tourniquet in calcaneal fracture can ensure a clear vision surgery, reduce the incidence of early postoperative pain and related complications, and promote functional rehabilitation. It is a new method worth recommending.