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WALANT Technique in Percutaneous Scaphoid Osteosynthesis.

Celso Ricardo Folberg1, Jairo André de Oliveira Alves2, Fernando Maurente Sirena Pereira2

  • 1Grupo de Cirurgia de Mão, Serviço de Ortopedia e Traumatologia, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brasil.

Revista Brasileira De Ortopedia
|December 21, 2022
PubMed
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This study introduces the Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique for percutaneous scaphoid osteosynthesis. WALANT allows immediate post-fixation wrist motion testing, enhancing scaphoid fracture treatment.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Anesthesiology

Background:

  • Scaphoid fractures are the most common carpal bone injuries, often treated with percutaneous osteosynthesis.
  • Current procedures typically involve general anesthesia or regional blocks, necessitating sedation and tourniquets.
  • The Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique offers a safe, cost-effective alternative in hand surgery.

Purpose of the Study:

  • To describe the application of the WALANT technique for percutaneous scaphoid osteosynthesis.
  • To detail the use of WALANT in both dorsal and volar surgical approaches for scaphoid fractures.
  • To highlight the advantages of WALANT in scaphoid fracture fixation.

Main Methods:

  • Percutaneous scaphoid osteosynthesis using dorsal or volar approaches.
Keywords:
fractures, bonelocal anesthesia/administration and dosagelocal anesthesia/methodsscaphoid bonewrist

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  • Administration of local anesthesia with epinephrine, eliminating the need for a tourniquet and sedation.
  • Immediate testing of active wrist and hand motion post-fixation.

    • Main Results:

    • The WALANT technique was successfully applied to percutaneous scaphoid osteosynthesis.
    • The described technique allows for immediate assessment of fixation stability through active motion.
    • No published literature previously addressed WALANT for percutaneous scaphoid osteosynthesis.

    Conclusions:

    • The WALANT technique is a viable and advantageous option for percutaneous scaphoid osteosynthesis.
    • This technique facilitates immediate functional testing, potentially improving patient outcomes.
    • Further research may explore the broader adoption of WALANT in scaphoid fracture management.