Ultrastructural analysis of the alterations in skeletal muscle during tourniquet application on extremities

In this study, the structural alterations in skeletal muscle due to tourniquet application and the relationship between these alterations and duration of tourniquet were analyzed. For this purpose, muscle biopsy was made from m. extensor digitorum in 6 male patients who were between 15 and 18 years old and who were surgically treated because of forearm fracture. Electron microscopic examination of the specimens revealed that mild structural alterations existed within the first hour. Muscle atrophy findings, interfibrillary edema and endothelial basal lamina thickening were observed after a tourniquet application time more than one hour. It was concluded that, especially more than one hour period of tourniquet application led to significant structural alterations in skeletal muscle.