Adoption of the Wide-Awake Local Anesthesia No Tourniquet Technique in Hand Surgery.

» Wide-awake local anesthesia no tourniquet (WALANT) technique featuring tumescent infiltration of lidocaine with epinephrine at the operative site has broad application in hand surgery including both soft-tissue and bone procedures.» The advantages of wide-awake anesthesia include high patient satisfaction, preserved intraoperative finger and wrist motion, cost-effectiveness, improved operating room efficiency, fewer opioids during recovery, and improved access to hand surgery, which may be performed in an office-based setting without the need for anesthesia personnel.» In properly selected patients, use of lidocaine with epinephrine in the hand and fingers is safe.

Stacked 1/3 Tubular Plates for Fixation of Pediatric Forearm Fractures: A Biomechanical Study.

Introduction: Among operatively treated pediatric forearm fractures, many different fixation constructs are described. The goal of this study was to define the biomechanical properties of a double stacked 1/3 tubular plate construct used by the senior author for some fractures and to review available literature regarding the use of stacked plates.

Methods: Biomechanical testing was performed by 4-point bending of three different plate constructs: 1/3 tubular plate, stacked 1/3 tubular plates, and 2.