Fracturas de radio distal: ¿El uso del torniquete afecta el desarrollo del tratamiento?

Abstract

Distal radius fractures are frequent in the world population, several classifications have been used, being the one most frequently used by Fernández, receiving surgical treatment the majority of injuries that affect the wrist joint. The use of tourniquet has been used to reduce surgical time, to improve the visualization of the surgical field, with postoperative pain equal to the non-use of the same and without major complications. The objective of this study was to analyze trans surgical time, bleeding and post- surgical pain with and without the use of the compression cuff in intra articular distal radius fractures.

A randomized, controlled, randomized clinical study was conducted in a sample of 24 subjects with a diagnosis of distal radius fracture Fernández type III or AO 23-C2.
Main measurements: use of tourniquet, bleeding, time of surgery, pain.
As results we found no postoperative complications were observed in any group. Consolidation was observed in all cases. There was no difference by sex, injured limb or laterality (p> 0.05). The mean age was 50.71 ± 17.6 years. The median pain score (VAS) at day one was 4.5, with a range of 2 to 7; At discharge was 2, with a range of 1 to 4 points and in the control was 1 with a range of 1 to 2. The time of surgery without tourniquet was 90.83 ± 17.43 minutes, 95% CI: 80, 29-101. The surgery time with tourniquet was 95.42 ± 20.27 min; 95% CI: 83.17 -107.67 min. Although the surgery time is shorter with the use of tourniquet, however, this is not statistically significant with a value of 0.095 (p> 0.05). It was observed that there was statistically significant difference in bleeding: with tourniquet 32.9 c.c. Versus 108.3 c.c. Without tourniquet (p <0.05). In relation to pain, there is a decrease in pain between the first and second evaluation in the same groups (p <0.05), but there is no difference in the last evaluation between groups (p> 0.05). As conclusions the use of tourniquet decreases trans surgical bleeding by improving the visual field.