Pneumatic tourniquet paralysis. Case report.

We describe a 31-year-old man in whom a paresis and sensory defect of the left arm developed after amputation of the index finger. The operation was performed in a bloodless field, using a pneumatic tourniquet. The sensory defect resolved in two months and the paresis in five and a half months. We consider that direct pressure produced by the tourniquet caused the nerve lesion. It is probable that the tourniquet was inflated to a pressure of 500 millimetres of mercury instead of the intended 250 millimetres of mercury because of a faulty gauge. In order to avoid this rare complication, it is advisable to check the tourniquet gauge each time before use.

[1]  W. Brown,et al.  The pathogenesis of pneumatic tourniquet paralysis in man. , 1981, Journal of neurology, neurosurgery, and psychiatry.

[2]  G. Waylonis,et al.  Electromyographic changes in postmeniscectomy patients. Role of the pneumatic tourniquet. , 1979, Journal of the American Medical Association (JAMA).

[3]  C. Bolton,et al.  Human pneumatic tourniquet paralysis , 1978, Neurology.

[4]  W. Trojaborg Prolonged conduction block with axonal degeneration. An electrophysiological study. , 1977, Journal of neurology, neurosurgery, and psychiatry.

[5]  P. Rudge,et al.  Tourniquet paralysis with prolonged conduction block. An electro-physiological study. , 1974, The Journal of bone and joint surgery. British volume.

[6]  T. J. Fowler,et al.  Anatomical changes in peripheral nerves compressed by a pneumatic tourniquet. , 1972, Journal of anatomy.

[7]  T. J. Fowler,et al.  Recovery of nerve conduction after a pneumatic tourniquet: observations on the hind-limb of the baboon1 , 1972, Journal of neurology, neurosurgery, and psychiatry.

[8]  A. Flatt Tourniquet time in hand surgery , 1972 .

[9]  E. F. Wilgis Observations on the effects of tourniquet ischemia. , 1971, The Journal of bone and joint surgery. American volume.

[10]  G. J. Romanes,et al.  Current Problems of Lower Vertebrate Phylogeny. , 1969 .

[11]  P. Lipscomb,et al.  A SAFETY DEVICE FOR A PNEUMATIC TOURNIQUET. , 1965, The Journal of bone and joint surgery. American volume.

[12]  V. Willman,et al.  Prolonged Tourniquet Ischemia of Extremities , 1960 .

[13]  J. Moldaver Tourniquet paralysis syndrome. , 1954, A.M.A. archives of surgery.

[14]  J. M. Bruner Safety factors in the use of the pneumatic tourniquet for hemostasis in surgery of the hand. , 1952, The Journal of bone and joint surgery. American volume.

[15]  P. Lewin,et al.  TOURNIQUET PARALYSIS: ANALYSIS OF THREE CASES OF SURGICALLY PROVED PERIPHERAL NERVE DAMAGE FOLLOWING USE OF RUBBER TOURNIQUET , 1945 .

[16]  F. M. Allen The tourniquet and local asphyxia , 1938 .

[17]  N. Eckhoff TOURNIQUET PARALYSIS.: A PLEA FOR THE EXTENDED USE OF THE PNEUMATIC TOURNIQUET , 1931 .

[18]  K. Solonen,et al.  Morphological changes in striated muscle during ischaemia. A clinical and histological study in man. , 1968, Acta orthopaedica Scandinavica.

[19]  J. M. Bruner SAFFTY FACTORS IN THE USE OF THE PNEUMATIC TOURNIQUET FOR HEMOSTASIS IN SURGERY OF THE HAND , 1951 .

[20]  D. Denny-Brown,et al.  PARALYSIS OF NERVE INDUCED BY DIRECT PRESSURE AND BY TOURNIQUET , 1944 .