Arch Hand Microsurg 2018; 23(4): 313-318  
Two Cases of Pneumatic Tourniquet Paralysis: Points for Prevention
Hyonsurk Kim, Young Ho Kim
Department of Plastic and Reconstructive Surgery, Dankook University College of Medicine, Cheonan, Korea
Correspondence to: Hyonsurk Kim
Department of Plastic and Reconstructive Surgery, Dankook University Hospital, 201 Manghyang-ro, Dongnam-gu, Cheonan 31116, Korea
TEL: +82-41-550-6285, FAX: +82-41-556-0524, E-mail: kruezel@gmail.com
Received: October 25, 2018; Revised: October 27, 2018; Accepted: November 4, 2018; Published online: December 1, 2018.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Although nerve injury is the most common complication of pneumatic tourniquets, it is said to be rare, with few case reports. We describe two cases of paralysis after upper extremity surgery to highlight this risk. Ulnar, median and radial neuropathies were diagnosed after surgery was performed on a man for left hand reconstruction, presumably due to a prolonged total inflation time of 14 hours despite conventional break times. A woman who received surgery for a crushed hand presented with radial neuropathy, the most probable cause being malfunction and automatic inflation of the tourniquet. These cases illustrate the diversity of tourniquet paralysis, with symptomatic progress not necessarily following electromyography results. The considerable discomfort to patients warrants careful use of tourniquets for neuropathy prevention.
Keywords: Upper extremity, Radial neuropathy, Ulnar neuropathy, Tourniquet


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