Fulchignoni Camillo, Bonetti Mario Alessandri, Rovere Giuseppe, Ziranu Antonio, Maccauro Giulio, Pataia Elisabetta
Department of Orthopedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome; Università Cattolica Del Sacro Cuore, Rome, Italy.
Orthop Rev (Pavia). 2020 Jun 25;12(Suppl 1):8668. doi: 10.4081/or.2020.8668. eCollection 2020 Jun 29.
Flexor tendon injuries are extremely challenging conditions to manage for hand surgeons. Over the last few years enormous progress has been made for the treatment of these lesions with new surgical approaches being performed. One of these is the wideawake local anesthesia no tourniquet (WALANT) technique, also known as Wide Awake Technique that allows tendon repair under local anesthesia, enabling the tendon to move actively during surgery. Dynamic movement of the tendon during surgery is crucial for the orthopedic surgeon in order to understand if the tendon has been correctly repaired before leaving the operatory table. An electronic literature research was carried out on Pubmed, Google Scholars and Cochrane Library using ((Flexor tendon injury) OR (flexor tendon) OR (injury muscle tendon) OR (flexor pollicis longus tendon) AND ((wide awake repair) OR (wide awake) OR (wide awake hand surgery))as search terms. Authors believe that WALANT is an enormous add-on in the management of patients with flexor tendon injuries mainly because it allows direct visualization of the repair during flexion and extension movement of the fingers and also because it avoids general anesthesia or brachial plexus being more cost effective. The aim of these review was therefore to sum up the evidences available so far on the wade awake technique as an emerging treatment for patients with flexor tendon injuries.
对于手外科医生来说，屈肌腱损伤是极富挑战性的病症。在过去几年里，随着新的手术方法的应用，这些损伤的治疗取得了巨大进展。其中之一是清醒局麻无止血带（WALANT）技术，也被称为清醒技术，该技术允许在局部麻醉下进行肌腱修复，使肌腱在手术过程中能够主动活动。手术过程中肌腱的动态活动对于骨科医生来说至关重要，以便在离开手术台之前了解肌腱是否已正确修复。我们在PubMed、谷歌学术和考科蓝图书馆进行了电子文献检索，检索词为（屈肌腱损伤）或（屈肌腱）或（肌肉肌腱损伤）或（拇长屈肌腱）以及（清醒修复）或（清醒）或（清醒手部手术）。作者认为，WALANT在屈肌腱损伤患者的治疗中是一项巨大的补充，主要是因为它能在手指屈伸运动过程中直接观察修复情况，还因为它避免了全身麻醉或臂丛麻醉，更具成本效益。因此，本综述的目的是总结目前关于清醒技术作为屈肌腱损伤患者新兴治疗方法的现有证据。
