Meta-analysis on the efficacy of tourniquet on ankle trauma surgery

BACKGROUND: In our study, we used meta-analysis to study the efficacy of the tourniquet on ankle trauma surgery. Postoperative infection rate, deep venous thrombosis incidence, hospital stay, and joint range of motion were studied to compare the tourniquet and non-tourniquet groups and provide certain references for clinical decision. METHODS: We searched PubMed, MEDLINE, EMBASE, and the Cochrane controlled trials register for all publications about the efficacy of tourniquet published before November 2012. The quality of included studies was evaluated by two estimators. I(2)-test and Q-statistic were used for heterogeneity analysis. When there was heterogeneity between studies, the random effects model analysis was applied or else the fixed effects model analysis was used. RESULTS: Three studies were included with 166 patients suffering from ankle trauma surgery. There was no statistical difference (P >0.05) between the tourniquet and non-tourniquet groups on operation time (mean difference (MD) −5.45, 95% confidence intervals (CI): (−13.98, 3.09)), postoperative infection rate (relative risk (RR) 1.83, 95% CI: (0.65, 5.12)), and deep venous thrombosis incidence (RR 4.13, 95% CI: (0.47, 36.17)). But statistical significances were observed on hospital stays (MD 3.17, 95% CI: (1.39, 4.95)) and joint range of motion (MD − 5.25, 95% CI: (−9.61, −0.89)). CONCLUSIONS: In general, the efficacy of the tourniquet group is comparable to that of the non-tourniquet group. The non-tourniquet group achieved greater benefits for the joint range of motion and reduced the hospital stay. However, a larger number of primary studies is still required for future evaluation of tourniquet efficacy on ankle trauma surgery.