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DOI: 10.1055/s-0041-1726070
WALANT Technique in Percutaneous Scaphoid Osteosynthesis[*]
Artikel in mehreren Sprachen: português | English
Abstract
Scaphoid fractures account for 50 to 70% of all carpal bone fractures. Percutaneous scaphoid osteosynthesis can use the dorsal or volar approach, both with good results, and is most commonly performed under general anesthesia or regional nerve block. The wide-awake local anesthesia no tourniquet (WALANT) technique is already considered a safe and cost-effective technique in hand surgery around the world. Local anesthesia with epinephrine causes vasoconstriction, which obviates the need for tourniquet and, consequently, the need to use patient sedation. Thus, the possibility of testing fixation stability under physiological forces is another great advantage of using local anesthesia. In the technique described in the present paper, active wrist and hand motion can be tested immediately after scaphoid fixation. Wide-awake local anesthesia no tourniquet has been increasingly used in soft-tissue hand surgery and in the fixation of metacarpal and phalangeal fractures. However, to date, there is no published literature addressing the use of this technique in percutaneous scaphoid osteosynthesis. The purpose of the present technical note is to describe the use of WALANT for both the dorsal and volar approaches in percutaneous scaphoid osteosynthesis.
Keywords
local anesthesia/methods - local anesthesia/administration and dosage - scaphoid bone - wrist - fractures, boneFinancial Support
There was no financial support from any public, commercial, or non-profit sources.
* Study developed at the Hand Surgery Group, Orthopedics and Traumatology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Publikationsverlauf
Eingereicht: 01. November 2020
Angenommen: 01. Dezember 2020
Artikel online veröffentlicht:
25. April 2022
© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Referências
- 1 Folberg C, Ruschel P, Pignataro M, Perea C, Caputo G. Percutaneous fixation of mid-third wrist scaphoid bone fractures. Rev Bras Ortop 2004; 39 (07) 363-370
- 2 Kang KB, Kim HJ, Park JH, Shin YS. Comparison of Dorsal and Volar Percutaneous Approaches in Acute Scaphoid Fractures: A Meta-Analysis. PLoS One 2016; 11 (09) e0162779
- 3 McKee DE, Lalonde DH, Thoma A, Glennie DL, Hayward JE. Optimal Time Delay between Epinephrine Injection and Incision to Minimize Bleeding: Plastic and Reconstructive Surgery . 2013; 131 (04) 811-814
- 4 Pires Neto P, Moreira L, De Las Casas P. É seguro o uso de anestésico local com adrenalina na cirurgia da mão? Técnica WALANT. Rev Bras Ortop 2017; 52 (04) 383-389
- 5 Gaffen AS, Haas DA. Survey of local anesthetic use by Ontario dentists. J Can Dent Assoc 2009; 75 (09) 649
- 6 Lalonde DH, Wong A. Dosage of local anesthesia in wide awake hand surgery. J Hand Surg Am 2013; 38 (10) 2025-2028
- 7 Mann T, Hammert WC. Epinephrine and hand surgery. J Hand Surg Am 2012; 37 (06) 1254-1256
- 8 Lalonde DH. Conceptual origins, current practice, and views of wide awake hand surgery. J Hand Surg Eur Vol 2017; 42 (09) 886-895
- 9 Ahmad AA, Yi LM, Ahmad AR. Plating of Distal Radius Fracture Using the Wide-Awake Anesthesia Technique. J Hand Surg Am 2018; 43 (11) 1045.e1-1045.e5