Gonzalez-Torres Christian, Deliz-Jimenez David, Claudio-Marcano Alexandra, Donestevez-Antuñano Javier, Roura-Rovira Raul, Foy-Parrilla Christian
Orthopaedic Surgery Department, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
Orthopaedic Surgery Department, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
Int J Surg Case Rep. 2023 Sep;110:108746. doi: 10.1016/j.ijscr.2023.108746. Epub 2023 Aug 28.
Wide Awake Local Anesthesia No Tourniquet (WALANT) is a surgical technique used in hand surgery that allows for active patient participation during surgery while avoiding the pain and discomfort associated with general anesthesia and tourniquets. Using this technique for tenolysis enables a surgeon to assess the repair intraoperatively. However, this technique is more commonly used in adults than in pediatric patients. We aimed to present a case that may contribute to the use of the WALANT technique on the pediatric population.
This case presents the successful use of the WALANT technique multiple times in a 7-year-old Hispanic male patient to repair recurrent tendon adhesions and joint contracture due to a prior gunshot wound that caused a comminuted, displaced fracture with intra-articular extension of the third finger.
To the best of our knowledge, few reports and case series of WALANT hand surgery in children are available within the literature. The presented case is rare in terms of the mechanism of injury, the age of the patient, and the fact that multiple WALANT interventions were successfully performed on the same patient.
Our findings showcase the potential of the WALANT technique on pediatric patients as an alternative to traditional techniques. Due to the scarcity of pediatric WALANT cases in the literature, and the benefits provided by the technique, this case report may be of clinical relevance.
清醒局麻无止血带（WALANT）是一种在手外科手术中使用的技术，它能让患者在手术过程中积极参与，同时避免全身麻醉和止血带带来的疼痛与不适。使用该技术进行肌腱松解术可使外科医生在术中评估修复情况。然而，这项技术在成人中比在儿科患者中更常用。我们旨在呈现一个可能有助于在儿科人群中应用WALANT技术的病例。
本病例展示了在一名7岁西班牙裔男性患者中多次成功使用WALANT技术，以修复因先前枪伤导致的复发性肌腱粘连和关节挛缩，该枪伤造成了第三指粉碎性、移位性骨折并累及关节内。
据我们所知，文献中关于儿童WALANT手部手术的报道和病例系列很少。就损伤机制、患者年龄以及在同一患者身上成功进行多次WALANT干预这一事实而言，本病例很罕见。
我们的研究结果展示了WALANT技术在儿科患者中作为传统技术替代方法的潜力。鉴于文献中儿科WALANT病例稀缺，且该技术具有诸多益处，本病例报告可能具有临床相关性。
