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.

中文翻译：

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比较踝关节骨折手术治疗中使用充气止血带和不使用止血带的再次手术风险。


目的 气动止血带常用于不稳定外伤性踝关节骨折的手术治疗。本研究的目的是评估使用和不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。方法 这是一项基于人群的队列研究，使用丹麦骨折数据库的数据，随访期为 24 个月。数据与丹麦国家患者登记处相关联，以确保有关因并发症而再次手术的完整信息，并发症分为严重和轻微。使用 Cox 比例风险模型估计止血带组与非止血带组再次手术的相对风险。结果 2012年3月15日至2016年12月31日期间，共纳入切开复位内固定治疗的踝关节骨折4050例，其中使用止血带手术669例（16.5%），未使用止血带手术3381例（83.5%）。总体再手术风险为 28.2%，组间比较调整后相对风险为 1.46（95% CI 0.91 至 2.32）。使用止血带时因主要并发症导致的再次手术风险为 3.1%，不使用止血带时为 4.4%，调整后相对风险为 1.45（95% CI 0.91 至 2.32）。对于轻微并发症，再次手术的比例为 24.7% 和 23.9%，调整后相对风险为 0.99（95% CI 0.84 至 1.17）。结论 在比较使用和不使用气动止血带的手术治疗踝关节骨折时，我们发现再次手术率没有显着差异。