Surgical Field Quality Assessment and Complications in Distal Radius Fractures Using the Minimum Inflation Tourniquet Pressure.

Surgical Field Quality Assessment and Complications in Distal Radius Fractures Using the Minimum Inflation Tourniquet Pressure: Limb Occlusion Pressure Versus Arterial Occlusion Pressure. And Clinical, Radiological and Quality of Life Assessment at One-year Follow up. A Randomized Controlled Trial.

Analyse surgical field bleeding, surgical time, and intraoperative pain in patients undergoing osteosynthesis of distal radius fractures using ischaemia pressure calculated based on Limb Occlusion Pressure, compared with Arterial Occlusion Pressure. Additionally, compare muscle damage and postoperative complications, and clinical, functional, quality of life and radiological outcomes at one-year follow-up.

Randomised controlled clinical trial. It will be conducted with patients undergoing osteosynthesis of distal radius fractures (ischaemia pressure calculated according to Arterial Occlusion Pressure or Limb Occlusion Pressure), included consecutively at Terrassa Hospital from June 2023 to October 2025. The estimated sample size will be 70 patients per group. Pneumatic cuff pressure, ischaemia time, intraoperative ischaemia-related pain, surgical field bleeding, muscle damage, and postoperative complications will be assessed. One-year follow-up will include clinical, functional, quality-of-life, and radiological evaluations.

Inclusion Criteria:

• Patients aged 18 years or older, diagnosed with a distal radius fracture meeting surgical criteria.
• Surgery performed by the Hand Unit at Terrassa University Hospital.
• Axillary block as the anaesthetic technique.
• The surgeon completes all required study procedures.
• Written informed consent obtained from the patient.

Exclusion Criteria:

• Bilateral distal radius fractures.
• Osteosynthesis of an ipsilateral distal ulnar fracture.
• Requirement for general anaesthesia.
• High anaesthetic risk (ASA IV).
• Body mass index (BMI) > 40.
• Uncontrolled hypertension or treatment with more than three antihypertensive medications.
• Contraindications to tourniquet use, such as arteriovenous fistulas or peripheral vascular disease.
• Failure of the surgeon to complete the required study procedures.
• Lack of informed consent for participation in the study.