Orbach Hagay, Rozen Nimrod, Rubin Guy
1 Orthopedic Department, Emek Medical Center, Afula, Israel.
2 Faculty of Medicine, Technion, Haifa, Israel.
J Int Med Res. 2018 Oct;46(10):4269-4276. doi: 10.1177/0300060518793036. Epub 2018 Aug 15.
Objective The use of wide-awake local anesthesia with no tourniquet (WALANT) is becoming an excellent alternative for elective hand surgeries and hand surgeries involving minor trauma. Although the use of WALANT for some soft tissue surgeries has become the state of the art, data regarding bony procedures, such as fracture management, under WALANT are limited. This study was performed to assess the WALANT technique for open reduction and internal fixation of distal radius fractures. Methods Five patients with displaced distal radius fractures were enrolled in the study. WALANT was carried out about 30 minutes prior to the first incision. Surgery was performed in the normal fashion, and the fractures were fixed using anatomic locking plates. After surgery, the patients were admitted overnight for observation and pain assessment, and they were discharged within 24 hours postoperatively. Intraoperative and postoperative complications were recorded. Follow-up was performed in our outpatient clinic. No abnormalities were recorded. Results All patients underwent a successful painless surgery. No extra bleeding or other complications were recorded. Conclusion The WALANT technique offers a simple and safe alternative to traditional anesthetic techniques for open reduction and plating of distal radius fractures.
目的 无止血带清醒局部麻醉（WALANT）正成为择期手部手术及涉及轻度创伤的手部手术的一种极佳替代方法。尽管WALANT在一些软组织手术中的应用已成为业内水平，但关于在WALANT下进行诸如骨折处理等骨手术的数据有限。本研究旨在评估WALANT技术用于桡骨远端骨折切开复位内固定术的效果。方法 五例桡骨远端移位骨折患者纳入本研究。在首次切开前约30分钟实施WALANT。手术按常规方式进行，骨折采用解剖锁定钢板固定。术后患者留院观察过夜并进行疼痛评估，术后24小时内出院。记录术中及术后并发症。在我们的门诊进行随访。未记录到异常情况。结果 所有患者均成功接受了无痛手术。未记录到额外出血或其他并发症。结论 对于桡骨远端骨折切开复位及钢板固定术，WALANT技术为传统麻醉技术提供了一种简单且安全的替代方法。
