Chirurgie de la Main 2012-12-01

[Long-term functional outcomes of digital ischemia under tourniquet: observations in three cases].

F Mallard, Y Saint-Cast, J Richou, D Le Nen

文献索引：Chir. Main 31(6) , 358-63, (2012)

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摘要

Digital tourniquet is a quick, simple and reliable method to ensure a bloodless operative field distal to the MP joint. However, a forgotten tourniquet is an exceptional but serious complication related to digital ischemia. Few cases were reported in literature without a long-term outcome. Three digits of three patients, aged 70, 49 and 14 at the time of accident, had a tourniquet left in place for 2 days for the first two and 6 days for the last one. Final assessment was carried out 3, 4 and 16 years respectively after the initial accident. All fingers survived with sequelae such as pain, cold intolerance, dysesthesia, allodynia, joint stiffness and skin and nail trophic disorders. A hypertrophic scar was still visible at the site of the tourniquet. Capillary pulse was normal in all cases. Radiological changes were visible when the tourniquet had been left for more than 2 days. The impact on professional and day life activities was considerable. No surgery for the sequelae was done. Avoiding a missed finger tourniquet requires a suitable tourniquet with a visual reminder and its removal must be considered a crucial part of the surgery.Copyright © 2012. Published by Elsevier SAS.