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腕部局部麻醉下无止血带技术(WALANT)治疗桡骨远端骨折的疗效——病例系列

The Efficacy of WALANT Technique in the Management of Distal End Radius Fracture - A Case Series.

作者信息

Sarode Rohan N, Chaudhary Sumedh D, Sakharkar Nilesh S, Adewar Aniket N, Jain Prateek, Giri Vishal

机构信息

Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India.

出版信息

J Orthop Case Rep. 2024 Mar;14(3):29-34. doi: 10.13107/jocr.2024.v14.i03.4276.

Abstract

INTRODUCTION

To improve hemostasis and visibility, a tourniquet was used throughout the majority of hand and wrist procedures, despite the fact that patient experience unnecessary and excruciating pain from the tourniquet. The more current method known as wide-awake local anesthesia without tourniquet (WALANT) enables intraoperative function evaluation while the patient is completely conscious.

MATERIALS AND METHODS

Individuals with displaced distal radius fractures that required surgery and isolated, non-concomitant injuries requiring spinal or general anesthesia were considered for WALANT technique. In our study, five patients underwent dorsal plate fixation and five patients underwent volar plate fixation. Patients receiving dorsal plate fixation required definite dorsal buttress to prevent radiocarpal dislocation.

CONCLUSION

The WALANT technique is a simple, reliable, and effective anesthetic method for internal fixation and open reduction of distal radius fractures. Since a tourniquet is not necessary, the patient is protected from the discomfort and risks associated with one.

摘要

引言

为了改善止血效果和视野清晰度,在大多数手部和腕部手术中都会使用止血带,尽管患者会因止血带遭受不必要的剧痛。目前更为先进的方法是无止血带清醒局部麻醉(WALANT),它能在患者完全清醒的状态下进行术中功能评估。

材料与方法

对于需要手术治疗的桡骨远端移位骨折患者,以及需要脊髓或全身麻醉的孤立性、非合并性损伤患者,考虑采用WALANT技术。在我们的研究中,5例患者接受了背侧钢板固定,5例患者接受了掌侧钢板固定。接受背侧钢板固定的患者需要明确的背侧支撑以防止桡腕关节脱位。

结论

WALANT技术是一种用于桡骨远端骨折切开复位内固定的简单、可靠且有效的麻醉方法。由于无需使用止血带,患者可免受与之相关的不适和风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97b6/10976537/7f3c407d08b4/JOCR-14-29-g001.jpg

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