Tourniquet application is a widely accepted adjuvant technique in extremity surgery. The purpose of this prospective, randomized trial was to evaluate the effect of cuff width on skeletal muscle ischemia-reperfusion injury. A 2- or 4-cm wide curved tourniquet cuff was applied around the midthigh of 36 New Zealand White rabbits and inflated to a pressure of 200 or 400 mm Hg for 2 hours: group A=2 cm to 200 mm Hg; group B=2 cm to 400 mm Hg; group C=4 cm to 200 mm Hg; group D=4 cm to 400 mm Hg. Blood levels of potassium, lactic acid, urea, lactic dehydrogenase, and creatinine phosphokinase MM isoenzyme (CPK-MM) were measured as basic indicators for limb ischemia before tourniquet inflation and 1, 5, and 30 minutes after cuff release.Potassium values did not differ among the 4 groups. Lactic acid and urea concentrations were always higher in the 400 mm Hg groups (B and D) (P<.001). However, cuff width did not affect their levels (P>.16). Lactic dehydrogenase and CPK-MM values were also greater in the 400 mm Hg groups at all times (P<.001). Further subgroup analysis of 200 mm Hg pressure groups showed higher lactic dehydrogenase (P<.02) but not CPK-MM (P>.9) concentrations in group C than in group A during the 30-minute period. At 400 mm Hg, lactic dehydrogenase and CPK-MM values were higher in group D compared with group B only 30 minutes after cuff deflation (P<.001). Broad tourniquets are associated with significantly greater and prolonged elevation of serum biochemical markers of inducible skeletal muscle ischemia-reperfusion injury compared with narrow ones. This difference is more prominent when a wide cuff is inflated to a high pressure.

Material and Methods We retrospectively reviewed the data of files of 1972 patients with ACL rupture, which were treated with ACL reconstruction in our Department over the last 27 years. ACL reconstruction complications were divided in two main categories: intraoperative complications and postoperative complications. All complications occurred during the operation and up to 2 (two) years postoperatively were recorded and included in this study. The term "preoperative complications" has been used by other authors 2 in ACL reconstruction, but in our opinion is not accurate. Preoperative planning is very important in the final outcome of ACL reconstruction, but wrong decisions are not complications. As a result, preoperative planning is not discussed in this article. In our perspective, graft failure is a bad clinical outcome and not a complication. Consequently, graft failure will not be reported as a complication in this study.

Skeletal osteochondroma or osteocartilaginous exostosis represent the most common tumor of all benign bone tumors and 10-15% of all bone tumors 1 . It is a benign cartilagecapped outgrowth, connected to bone by a stalk. It can be either isolated or as part of a syndrome (Hereditary Multiple Exostosis-HME) and its progression usually stops when the skeleton is mature, after the closure of the growth plate 2 .This lesion usually involves long bones 95%, especially near the knee 36%. It can rarely be found on flat bones,