Niempoog Sunyarn, Tanariyakul Yot, Jaroenporn Woraphon
Department of Orthopaedic Surgery, Thammasat University, Pathum Thani, Thailand.
Department of Orthopaedic Surgery Police General Hospital, Bangkok, Thailand.
Int J Surg Case Rep. 2021 Feb;79:112-115. doi: 10.1016/j.ijscr.2021.01.005. Epub 2021 Jan 6.
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.
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.
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.
Clavicular fixation can be performed successfully and without any complication under WALANT technique.
清醒局部麻醉无止血带(WALANT)技术已在许多骨科手术中使用。该技术的优点是避免全身麻醉(GA)的不良反应并总体降低手术成本。然而,文献检索未发现关于在锁骨骨折手术中应用WALANT技术的已发表报告。
我们报告一例锁骨中段骨折病例,该病例在一名患有无法控制的心房颤动的患者中使用WALANT技术进行钢板内固定治疗。手术过程中,患者未感到任何疼痛,且由于手术视野出血极少,手术得以轻松进行。手术成功完成,无任何并发症,患者术后第二天出院。三个月后的随访X线片显示骨折部位锁骨愈合,患者可正常使用手臂。
锁骨骨折通常在全身麻醉下进行钢板内固定治疗。对于一些发病率高且有其他全身麻醉不适用风险因素的患者,WALANT技术可能是一种有效的替代方法。
在WALANT技术下,锁骨固定可以成功进行且无任何并发症。