Network meta-analysis comparing WALANT, locoregional, local and general anesthesia techniques in carpal tunnel release.

Purpose: To compare anesthesia techniques (WALANT (wide-awake anesthesia no tourniquet), locoregional anesthesia, local anesthesia with tourniquet or sedation) for carpal tunnel release (CTR).

Methods: A comprehensive literature search was conducted on PubMed, MEDLINE, Embase and the Cochrane Library up to May 2023. Two independent reviewers selected the studies and extracted the data.

The emerging field of ultrasound-guided nerve decompression surgery: a narrative review.

Introduction: The development of high-frequency ultrasound technology has transformed musculoskeletal diagnostic practices, offering detailed, multi-plane visualization of superficial structures with remarkable precision and comfort. This non-invasive, pain-free modality is particularly suited for patients of all ages, including children.

Purpose: Ultrasound serves as a valuable adjunct to clinical evaluations by facilitating the identification of conditions such as tumours, tenosynovitis, fractures, and nerve entrapments.

Radial nerve at Fhrose's arcade: a new technique of release under total ultrasound guidance. First experience.

Radial nerve compression at the arcade of Frohse is a rare but significant condition that typically presents with pain primarily after exertion and at night on the dorsal side of the forearm, more distally than tennis elbow pain, and weakness of the wrist extensors and the long fingers and thumb extensors. Traditional treatment often involves open surgery, resulting in significant scarring. This study introduces a novel percutaneous radial nerve release technique under complete ultrasound guidance and highlights its efficacy and safety.

Ultrasound-guided percutaneous release of the ulnar nerve at the elbow.

Introduction: Surgical treatment of ulnar tunnel syndrome is controversial, with no consensus on the ideal procedure. Nevertheless, in-situ decompression seems to provide faster recovery with less morbidity than neurolysis-transposition. The aim of this retrospective study was to validate a new percutaneous technique using ultrasonography.

Muscle activity analysis using electromyography during sensory collapse test: An experimental case report.

A 48-year-old right-handed male surgeon complained of finger numbness, pain, cramps and weakness of 2 years' progression, without improvement after 2 carpal tunnel corticosteroid injections and splinting. The patient was diagnosed with lacertus syndrome with Hagert's triad. Sensory collapse test was positive, but the sensations during the test were not consistent with the literature.

Lacertus syndrome: recent advances.

Lacertus syndrome consists in proximal median nerve entrapment with median nerve compression at the lacertus fibrosus, causing hand weakness and fatigue, forearm pain and occasional numbness. Recent advances emphasized the importance of clinical examination, due to limitations in electromyographic diagnosis and delayed diagnosis. The Hagert clinical triad, lacertus notch sign, lacertus antagonist test and taping help accurate diagnosis.

Description of WALANT technique in open bone and ligament wrist surgery.

The gold-standard for bone, ligament and joint surgery in the wrist is locoregional anesthesia in most countries. Wide-Awake Local Anesthesia No Tourniquet (WALANT) is commonly used for simple soft-tissue hand surgery procedures such as carpal tunnel or trigger finger release, and can now also be safely used in procedures such as proximal row carpectomy, scapholunate ligament repair or partial wrist fusion, to name but a few. This article describes the use of WALANT for complex surgery in the wrist.

From teaching to practice: Evaluating the impact of an upper-limb ultrasound surgery diploma on surgical practice.

Objectives: This study evaluates the impact of an upper-limb ultrasound surgery diploma on surgical practices, specifically assessing how this specialized training influences the adoption and application of ultrasound techniques in upper limb surgeries.

Material And Methods: A comprehensive survey was conducted from August to November 2023, targeting individuals who completed the upper-limb ultrasound surgery diploma program between 2013 and 2023. The survey, distributed online, comprised 31 questions spanning demographic information, professional background, specifics about the diploma program, motivations for pursuing the diploma, post-diploma practices, challenges faced, and financing of ultrasound equipment.

Wrist Hemiarthroplasty of Irreparable Distal Radius Fracture under Wide-Awake Local Anesthetic and No Tourniquet.

Distal radius fractures (DRF) are common in elderly patients and the incidence continues to increase with the aging of the population. For irreparable fractures in the elderly, treatment with a reduction cast leads to unreliable results and frequent complications when treated with an anterior plate. Recent studies on hemiarthroplasty for elderly complex wrist fractures have resulted in good clinical and radiologic outcomes, as well as high satisfaction rates.

Percutaneous Ultrasound-Guided Release of the Lacertus Fibrosus for Median Nerve Entrapment at the Elbow.

Purpose: The aim of this technical note is to present a microinvasive percutaneous ultrasound-guided release of the lacertus fibrosus of the biceps brachii for pronator syndrome, i.e., entrapment of the median nerve at the elbow.

Flexor Tendons Sonography.

Ultrasonography is the best examination to explore the flexor tendons anatomy and disorders from the wrist to the digit. It is the only dynamic and comparative tool easily accessible for the surgeon. Indeed, ultrasonography is always available in all the departments of your hospital.

Ultrasound-guided transection of the interosseous membrane of the forearm.

We sought to evaluate the feasibility of ultrasound-guided transection of the interosseous membrane of the forearm. The study involved ten forearms from five fresh cadavers. An ultrasound scanner (Toshiba™ Aplio V®, Toshigi, Japan) with a linear probe (Toshiba™ PLT-805AT 8Mhz) and a 25-cm long Kemis® knife (NewClip Technics™, Cholet, France), which was specially created for this study, were used.

Ultrasound-Guided de Quervain's Tendon Release, Feasibility, and First Outcomes.

 de Quervain's syndrome is one of the main tendonitis of the wrist. The hypothesis of authors was that de Quervain's syndrome could be successfully treated with a specific ultrasound-guided percutaneous procedure, as it is for trigger finger.  Identification of the subcompartmentalization of the first extensor compartment was performed first, using the Hiranuma's classification, prior to the surgery.

Arthroscopic Treatment of Symptomatic Congenital Lunotriquetral Coalition.

Symptomatic lunotriquetral coalition is very rare and need open surgery after failure of conservative treatment. We report a case of a symptomatic congenital lunotriquetral coalition type 1 according to the Minaar classification, at the left wrist of a 14-year-old boy. We performed an arthroscopic treatment with two compression screws and without cancellous bone grafting.

Ultrasonography for the orthopaedic surgeon.

The recent development of high-frequency ultrasonography transducers has provided better accuracy and improved the ability to image more superficial body structures. Ultrasonography is a widely available, inexpensive, comparative, and dynamic imaging technique that involves no radiation exposure and has no other adverse effects. Ultrasonography must always be combined with a medical history, physical examination, and radiographic assessment.

Surgical ultrasound-guided carpal tunnel release.

Ultrasound-guided surgery is a new trend stemming from the introduction of high-frequency linear probes and better quality screens. Surgical treatment of carpal tunnel syndrome is increasingly being performed under ultrasound guidance. Knowledge of musculoskeletal ultrasonography is obviously mandatory.

Wide-awake ultrasound-guided percutaneous extensor central slip tenotomy for chronic mallet finger: A prospective study of 14 cases (with videos).

The central slip tenotomy described by Fowler is an effective option for treating chronic mallet finger in order to avoid swan neck deformity of the finger. In a prospective study of 14 cases (13 failures of conservative treatment and one case of untreated mallet finger), we performed percutaneous ultrasound-guided central slip tenotomy with a 19 G needle using the wide-awake local anesthesia and no tourniquet (WALANT) technique. The mean extensor lag before surgery was 28° (range 20°-40°) and three patients had a swan neck deformity.

Continuous in situ diffusion of ropivacaine for ambulatory congenital hand disorders surgery in young children.

Pediatric ambulatory surgery presents a specific set of challenges to the anesthesiologist. Similarly to adult ambulatory surgery, we report four ambulatory surgical procedures in two young children with congenital hand disorders. For each surgical procedure pain was controlled with continuous in situ infusion of ropivacaine.