Wide Awake Hand Surgery Under Local Anesthesia No Tourniquet in South America

The authors report the introduction and development of wide awake hand surgery under local anesthesia no tourniquet (WALANT) in South America, specifically in Brazil, where thousands of cases have already been performed with this technique. This was largely stimulated by Dr Lalonde's first visit to Brazil in 2012. The authors began with smaller procedures such as trigger fingers and carpal tunnels, which were easily implemented. There has been an increase in the number of more complex procedures, such as flexor tenolysis or tendon transfers, in which patient cooperation can help improve results.