Foot & ankle international
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A clinical study was undertaken to ascertain the utility and complication rate of proximal calf tourniquet use for foot and ankle surgery. The surgical and clinical records of 446 patients undergoing foot and ankle surgery between March 1992 and December 1994 were examined for details pertaining to intraoperative tourniquet use and postoperative evidence of neurologic or vascular complications. All patients who had surgery performed under tourniquet control were included in the study. ⋯ No postoperative compromise to either neurologic or vascular function was detected. Specifically, no alteration in peroneal nerve function was seen. We conclude that a calf tourniquet placed proximally with adequate cast padding is a safe and effective method to achieve a bloodless surgical field for foot and ankle surgery.
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Twenty patients received the installation of contrast material into the peroneal tendons while local anesthetic was injected as a diagnostic test. In three patients (15%), communication with the ankle joint and subtalar joint was noted, as well as failure of the contrast to fill the distal tendon. Injection of local anesthetic into the peroneal tendons as a diagnostic measure, therefore, may not have 100% sensitivity of specificity. Simultaneous injection of contrast material can be used to alert the clinician to a lack of specificity of the anesthetic test injection.