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Arch Hand Microsurg > Volume 23(4); 2018 > Article
Archives of Hand and Microsurgery 2018;23(4):313-318.
Published online December 1, 2018.
DOI: https://doi.org/10.12790/ahm.2018.23.4.313   
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. kruezel@gmail.com
Received: 25 October 2018   • Revised: 27 October 2018   • Accepted: 4 November 2018
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.
Key Words: Upper extremity, Radial neuropathy, Ulnar neuropathy, Tourniquet
 
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