Introduction: The wide-awake local anesthesia no tourniquet (WALANT) technique has been used in many orthopedic surgeries. The benefits of this technique are the avoidance of the adverse effects of general anesthesia (GA) and the overall reduction of the cost of surgery. However, a literature search revealed no published report on performing the WALANT technique for clavicular fracture surgery.
Presentation Of Case: We report a case of mid-shaft clavicular fracture that was treated with plate osteosynthesis using the WALANT technique in a patient with uncontrolled atrial fibrillation. During the operation, the patient did not experience any pain, and the procedure could be performed easily due to minimal bleeding in the operative field. The operation was completed successfully without any complications, and the patient was discharged from the hospital the day after surgery. Follow-up radiographs after three months showed union of the clavicle at the fracture site, and the patient could use his arm normally.
Discussion: Clavicular fracture is routinely treated with plate osteosynthesis under general anesthesia. In some patients with high morbidity and other risk factors for whom GA is unsuitable, the WALANT technique can prove to be an effective alternative.
Conclusion: Clavicular fixation can be performed successfully and without any complication under WALANT technique.
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http://dx.doi.org/10.1016/j.ijscr.2021.01.005 | DOI Listing |
Cureus
December 2024
Histopathology, Government Medical College, Srinagar, Srinagar, IND.
Wide-awake surgery of the hand was surrounded by a lot of apprehension, mainly over concerns around using epinephrine near digits and its potential to cause digital ischemia and necrosis. With multiple reports underlining its safety and effectiveness, it is now being widely adopted in hand and wrist surgery. The British Society for Surgery of the Hand has already published guidelines on operating outside of main theatres, with an emphasis on wide awake local anaesthesia no tourniquet (WALANT).
View Article and Find Full Text PDFJ Hand Surg Am
December 2024
Department of Orthopaedic Surgery, The University of Chicago Medical Center, Chicago, IL.
Purpose: To study if patients who would be deemed high-risk individuals by traditional classifications of American Society of Anesthesiologists (ASA) or the updated guidelines of ASA Practice Advisory (ASAPA) can safely undergo surgery under wide-awake local anesthesia, no tourniquet in a procedure room setting without any increased risks of complications.
Methods: We analyzed 436 surgeries performed in our procedure room over a 4-year period. No medical comorbidities precluded a patient from surgery within the procedure room, and no preoperative clearance was required.
J Hand Surg Glob Online
November 2024
Department of Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Purpose: The purpose of this study was to comprehensively evaluate clinical outcome reporting in hand surgery randomized controlled trials (RCTs), using wide-awake local anesthesia no tourniquet (WALANT) studies as a model.
Methods: This International Prospective Register of Systematic Reviews-registered systematic review (CRD42023461653) adheres to preferred reporting items for systematic reviews and meta-analysis guidelines, focusing on RCTs evaluating WALANT in hand and upper limb surgery. A systematic search across five databases was conducted to include all eligible articles from inception until search date (April 1, 2023).
J Hand Surg Glob Online
November 2024
Hand and Microsurgery Unit, Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangasaan Malaysia, Kuala Lumpur, Malaysia.
Purpose: Fixation of metacarpal or phalanx bone fractures is usually performed under general anesthesia (GA) or regional anesthesia and with the use of a tourniquet to minimize bleeding. However, the use of tourniquet causes pain and discomfort after surgery. Wide-awake local anesthesia no tourniquet (WALANT) enables the surgery to be performed with the patient fully awake and without a tourniquet, which allows intraoperative assessment of function during surgery.
View Article and Find Full Text PDFJ Hand Microsurg
December 2024
Department of Orthopaedic Surgery, Centre hospitalier de Montauban, 100 rue Léon Cladel, 82000, Montauban, France.
Introduction: The simultaneous bilateral release of carpal tunnels still remains a non-unanimous practice. We prospectively studied the contribution of ultrasound-guided surgery coupled with Walant anaesthesia in the simultaneous release of both carpal tunnels.
Materials And Methods: Patients who presented bilateral clinical involvement confirmed by electromyogram were operated on in the operating room under Walant anaesthesia by minimally invasive knife section under ultrasound guidance.
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