Use of a tourniquet in the internal fixation of fractures of the distal part of the fibula. A prospective, randomized trial

J Bone Joint Surg Am. 1993 May;75(5):700-3. doi: 10.2106/00004623-199305000-00009.


A prospective, randomized trial was undertaken to determine the rate of complications after the use of a tourniquet during open reduction and internal fixation of simple, closed fractures of the distal part of the fibula. Forty patients were operated on with use of a tourniquet (Group 1) and forty patients, without use of a tourniquet (Group 2). The average duration of the operation was significantly different between the two groups (41 +/- 9 minutes for Group 1 compared with 53 +/- 12 minutes for Group 2 [p = 0.026]). There were more complications in the patients in Group 1, two of whom had an isolated deep-vein thrombosis of the calf. The wound was possibly infected in eleven patients (seven in Group 1 and four in Group 2 [p < 0.05]) and frankly infected in three patients, all in Group 1 (p < 0.05). The plaster-of-Paris cast needed to be changed in three patients from Group 1. The patients in Group 1 returned to work an average of one week later than those in Group 2. The mean duration of follow-up was eighteen months (range, nine to thirty-two months). Given the lower prevalence of postoperative complications and the shorter time to recovery for the patients in Group 2, we believe that it is justified not to use a tourniquet in the operative treatment of simple, isolated fibular fractures.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Fibula / injuries*
  • Fibula / surgery
  • Fracture Fixation, Internal / methods
  • Fractures, Closed / rehabilitation
  • Fractures, Closed / surgery*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Prospective Studies
  • Tourniquets / adverse effects*