Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2024; 15(6): 498-500
Published online Jun 18, 2024. doi: 10.5312/wjo.v15.i6.498
Foot and ankle surgery: Tourniquet placement site to cause as little postoperative pain as possible
Emerito Carlos Rodriguez-Merchan
Emerito Carlos Rodriguez-Merchan, Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid 28046, Spain
Emerito Carlos Rodriguez-Merchan, Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital-Autonomous University of Madrid), Madrid 28046, Spain
Author contributions: Rodriguez-Merchan EC designed research, performed research, analyzed data and wrote the paper.
Conflict-of-interest statement: There is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/.
Corresponding author: Emerito Carlos Rodriguez-Merchan, PhD, Associate Professor, Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Paseo de la Castellana 261, Madrid 28046, Spain. ecrmerchan@hotmail.com
Received: January 22, 2024
Revised: April 28, 2024
Accepted: May 16, 2024
Published online: June 18, 2024
Processing time: 142 Days and 15.2 Hours
Abstract

There is controversy in the literature on where to place the tourniquet (thigh, calf, ankle) for foot and ankle surgery. While some authors prefer the ankle tourniquet to the calf tourniquet, others state that the surgeon can decide between using the thigh tourniquet or the ankle tourniquet, since there was no difference in postoperative pain between them. Where to place the tourniquet during foot and ankle surgery to cause the least possible postoperative pain to the patient as a result of the tourniquet is a common question in clinical practice. The reality is that, unfortunately, there is no consensus on this issue. Perhaps the only possible way to answer this question would be to conduct a comparative study with sufficient statistical power to reach scientifically sound conclusions. It does not seem easy to carry out such a study, but it would be important to be able to answer the question posed in the title of this Editorial once and for all.

Keywords: Surgery; Foot; Ankle; Tourniquet; Site; Postoperative pain

Core Tip: It is well known that the use of tourniquet produces postoperative pain, as evidenced by several authors. Another important question is where the tourniquet should be placed to produce less postoperative pain. The literature on where to place the tourniquet (thigh, calf, ankle) for foot and ankle surgery is controversial. While some authors prefer the ankle tourniquet to the calf tourniquet, others state that the surgeon can decide between using the thigh tourniquet or the ankle tourniquet, since there was no difference in postoperative pain between them.