ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Limb occlusion pressure-based individualized tourniquet pressure management in patients undergoing internal fixation for extremity fractures: a prospective comparative feasibility study.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to evaluate the feasibility of limb occlusion pressure (LOP)-based individualized tourniquet pressure management and to quantify the reduction in applied tourniquet pressure compared with a traditional fixed-pressure protocol in patients undergoing internal fixation for extremity fractures.
methodsA prospective comparative study was conducted at Civil Aviation Shanghai Hospital from January to September 2025. Patients undergoing internal fixation for extremity fractures were enrolled and allocated to either the LOP-based group (n = 171) or the traditional fixed-pressure group (n = 235) according to the attending surgical team and operative scheduling, without randomization. The LOP-based group received individualized tourniquet pressure based on preoperative LOP measurement plus a safety margin, while the control group received standardized pressures (40-50 kPa; 300-375 mmHg). The primary outcome was applied tourniquet inflation pressure. Secondary outcomes included demographic characteristics, extremity location, operative duration, and subgroup analyses stratified by extremity location, age, and sex; multivariable linear regression was performed to adjust for potential confounders.
resultsThe LOP-based group demonstrated significantly lower mean tourniquet pressure compared with the traditional group (32.82 +/- 3.63 kPa [246 +/- 27 mmHg] versus 48.21 +/- 3.84 kPa [362 +/- 29 mmHg]; mean difference: 15.39 kPa; 95% CI: 14.66-16.12; P < 0.001), representing a 31.93% reduction; the difference remained significant after adjustment for extremity location, age, and sex (adjusted mean difference: 15.71 kPa; 95% CI: 15.36-16.06; P < 0.001). Baseline characteristics including age (46.09 +/- 15.20 versus 47.51 +/- 15.66 years; P = 0.361), sex distribution (P = 0.809), extremity location (P = 0.457), and operative duration (82.80 +/- 46.64 versus 80.55 +/- 43.50 min; P = 0.618) were comparable between groups. Within the LOP-based group, applied pressure was lower for upper than for lower extremity procedures (26.24 +/- 4.21 versus 34.16 +/- 1.30 kPa; P < 0.001), while exploratory analyses revealed no significant pressure variations across sex (male: 32.97 +/- 3.52 kPa; female: 32.53 +/- 3.85 kPa; P = 0.445) or age categories (< 40, 40-59, >=60 years; P = 0.807). All procedures achieved adequate intraoperative hemostasis without pressure escalation.
conclusionsLOP-based individualized tourniquet pressure management was feasible and achieved a substantial reduction in applied tourniquet pressure while maintaining adequate intraoperative surgical field visualization in extremity fracture internal fixation. Applied pressure varied with extremity location but was independent of patient age and sex. Because patient-centered clinical outcomes were not assessed, these findings demonstrate the feasibility and pressure-reducing effect of LOP-based protocols rather than proven clinical superiority; randomized trials with clinical endpoints are warranted.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.