Tourniquet use in lower limb fracture surgery: a systematic review and meta-analysis

Martin Præstegaard, Elin Beisvåg, Julie Ladeby Erichsen, Michael Brix, Bjarke Viberg*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Background: Tourniquets are commonly used in today’s orthopaedic surgical practice, but little evidence is available regarding the links between the use of a tourniquet and the amount of post-operative pain and other complications. The aim of the study was to conduct a systematic review and meta-analysis comparing tourniquet versus non-tourniquet use during fracture surgery of the lower limb in adult patients. Method: A search was performed using the keyword “tourniquet” in EmBase and as a MeSH term in PubMed, and no limitations (including language) were applied. Available studies were screened using the Covidence software, and demographic as well as outcome data were extracted from the final studies. Critical appraisal was performed according to Cochrane Risk of Bias guidelines. Pooled data were assessed for heterogeneity using Chi-squared and I2 tests. Results: Five studies were included, and no statistically significant difference was found in the amount of pain and post-operative complications between tourniquet and non-tourniquet groups. Length of in-hospital stay was longer in the tourniquet groups. An overall high risk of bias was found in the included studies. Conclusion: Although the validity and statistical strength of our results are not strong enough to suggest a change in practice in tourniquet use, the operating surgeon should still carefully consider his or her decision to use a tourniquet in lower limb fracture surgery, as there are indeed complications associated with it and no current evidence to support its continued use. Level of evidence: Level I, systematic review of randomized controlled trials.

Original languageEnglish
JournalEuropean Journal of Orthopaedic Surgery and Traumatology
Issue number1
Pages (from-to)175-181
Publication statusPublished - 8. Jan 2019
EventDOS Congress 2018 -
Duration: 24. Oct 201826. Oct 2018


ConferenceDOS Congress 2018


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