Gök Ümit, Öktem Ferhat, Pamuk Çağdaş, Serttaş Muhammed Fatih, Olgun Hüseyin, Güçlü Seyit Ali
Orthopedics and Traumatology Department, Kocaeli City Hospital, University of Health Science, Kocaeli, Turkey.
Orthopedics and Traumatology Department, Private Silivri Anadolu Hospital, İstanbul, Turkey.
Medicine (Baltimore). 2025 Aug 8;104(32):e43921. doi: 10.1097/MD.0000000000043921.
Although several studies have demonstrated the successful use of wide-awake local anesthesia no tourniquet (WALANT) technique in cubital tunnel decompression, no prior study has investigated its use in anterior ulnar nerve transposition. This study aimed to retrospectively evaluate the outcomes of patients who underwent ulnar nerve decompression and subcutaneous anterior transposition using WALANT. A total of 41 surgeries were performed on 40 patients between August 2012 and March 2024 by a single surgeon. Patient data including age, sex, surgical side, Dellon satisfaction scale scores, postoperative complications, and satisfaction with anesthesia were collected. All procedures were performed using WALANT. Twelve (30%) patients were female and 28 (70%) were male and the mean postoperative follow-up period was 5.8 weeks (range 4-9 weeks). In the preoperative evaluation according to the Dellon scale, 12 (30%) patients had mild disease, 23 (57.5%) had moderate moderate, 5 (12.5%) had severe disease. Patient satisfaction was evaluated as bad in 3 patients (7.5%), moderate in 11 patients (27.5%) and good in 26 patients (65%). A significant negative correlation was observed between age and satisfaction questionnaire scores (r = -0.27, P = .023). Age also had a significant effect on the likelihood of conversion to general anesthesia (P = .0018). The WALANT anesthesia technique for anterior subcutaneous transposition of the ulnar nerve in cubital tunnel syndrome is safe and effective. The most important point in this regard is patient selection. A prospective cohort study with a larger cohort and longer follow-up time is required to monitor the long-term clinical outcomes.
尽管多项研究已证明清醒局部麻醉无止血带(WALANT)技术在肘管减压术中的成功应用,但此前尚无研究探讨其在前臂尺神经转位术中的应用。本研究旨在回顾性评估采用WALANT技术行尺神经减压及皮下前路转位术患者的治疗效果。2012年8月至2024年3月期间,由一名外科医生对40例患者共进行了41例手术。收集患者的年龄、性别、手术侧别、德龙满意度量表评分、术后并发症及麻醉满意度等数据。所有手术均采用WALANT技术。12例(30%)患者为女性,28例(70%)为男性,术后平均随访时间为5.8周(范围4 - 9周)。根据德龙量表进行的术前评估中,12例(30%)患者病情较轻,23例(57.5%)为中度,5例(12.5%)为重度。3例患者(7.5%)的患者满意度评估为差,11例(27.5%)为中等,26例(65%)为良好。年龄与满意度调查问卷评分之间存在显著负相关(r = -0.27,P = 0.023)。年龄对转为全身麻醉的可能性也有显著影响(P = 0.0018)。WALANT麻醉技术用于肘管综合征尺神经皮下前路转位术是安全有效的。在这方面最重要的一点是患者选择。需要进行一项更大样本量和更长随访时间的前瞻性队列研究来监测长期临床疗效。