Comparing the risk of reoperation between pneumatic tourniquet and non-tourniquet use in surgical treatment of ankle fractures.

IF 4.9 1区医学 Q1 ORTHOPEDICS Bone & Joint Journal Pub Date : 2024-09-01 DOI:10.1302/0301-620X.106B9.BJJ-2024-0225.R1

Issam El-Khaldi, Mads H Gude, Per H Gundtoft, Bjarke Viberg

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Abstract

Aims: Pneumatic tourniquets are often used during the surgical treatment of unstable traumatic ankle fractures. The aim of this study was to assess the risk of reoperation after open reduction and internal fixation of ankle fractures with and without the use of pneumatic tourniquets.

Methods: This was a population-based cohort study using data from the Danish Fracture Database with a follow-up period of 24 months. Data were linked to the Danish National Patient Registry to ensure complete information regarding reoperations due to complications, which were divided into major and minor. The relative risk of reoperations for the tourniquet group compared with the non-tourniquet group was estimated using Cox proportional hazards modelling.

Results: A total of 4,050 ankle fractures treated with open reduction and internal fixation between 15 March 2012 and 31 December 2016 were included, with 669 (16.5%) undergoing surgery with a tourniquet and 3,381 (83.5%) without a tourniquet. The overall reoperation risk was 28.2% with an adjusted relative risk of 1.46 (95% CI 0.91 to 2.32) for group comparison. The reoperation risk due to major complications was 3.1% with a tourniquet and 4.4% without a tourniquet, resulting in an adjusted relative risk of 1.45 (95% CI 0.91 to 2.32). For minor complications, there were 24.7% and 23.9% reoperations, resulting in an adjusted relative risk of 0.99 (95% CI 0.84 to 1.17).

Conclusion: We found no significant difference in the reoperation rate when comparing ankle fractures treated surgically with and without the use of pneumatic tourniquets.

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比较在踝关节骨折手术治疗中使用气动止血带和不使用止血带的再手术风险。

目的：气动止血带通常用于不稳定创伤性踝关节骨折的手术治疗。本研究旨在评估使用和未使用气动止血带的踝关节骨折切开复位内固定术后再次手术的风险：这是一项基于人群的队列研究，使用的数据来自丹麦骨折数据库，随访期为 24 个月。数据与丹麦国家患者登记处相连，以确保因并发症而再次手术的完整信息，并将并发症分为主要并发症和次要并发症。使用Cox比例危险模型估算了止血带组和非止血带组再次手术的相对风险：2012年3月15日至2016年12月31日期间，共有4050例踝关节骨折患者接受了开放复位和内固定治疗，其中669例（16.5%）接受了止血带手术，3381例（83.5%）未使用止血带。总体再手术风险为28.2%，组间比较的调整后相对风险为1.46（95% CI 0.91至2.32）。使用止血带和不使用止血带时，主要并发症导致的再手术风险分别为3.1%和4.4%，调整后的相对风险为1.45（95% CI 0.91至2.32）。在轻微并发症方面，再次手术的比例分别为24.7%和23.9%，调整后的相对风险为0.99（95% CI 0.84至1.17）：我们发现，在使用和不使用气动止血带进行手术治疗的踝关节骨折患者中，再次手术率没有明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

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