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Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

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Wide-Awake Olecranon Fracture Fixation: Is it Possible?

Celso Ricardo Folberg¹, Jairo André de Oliveira Alves¹, Fernando Maurente Sirena Pereira¹

¹Department of Orthopedics, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.

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|March 28, 2023

Summary

Wide-awake local anesthesia without a tourniquet is effective for olecranon fracture fixation, allowing immediate active motion testing. This technique offers a safe alternative for patients unsuitable for general anesthesia.

Keywords:

Elbow fracture Local anesthesia Olecranon fracture WALANT Wide-awake surgery

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Published on: January 5, 2015

Area of Science:

Orthopedic Surgery
Anesthesiology

Background:

The wide-awake local anesthesia no tourniquet (WALANT) technique is established in hand and wrist surgery.
Its application in elbow surgery, particularly for olecranon fractures, is less documented.

Purpose of the Study:

To describe the use of WALANT for olecranon fracture fixation.
To evaluate the feasibility and outcomes of this technique in a small case series.

Main Methods:

Tumescent anesthesia was administered to the proximal ulna and fracture site.
Olecranon fractures were fixed using a cancellous screw without a tourniquet.
Post-fixation, patients performed active elbow range-of-motion exercises.

Main Results:

Surgical procedures were successfully completed in all 4 cases.
Mild pain was reported by two patients during reaming, managed with additional anesthesia or mild sedation.
All patients achieved active elbow motion post-surgery.

Conclusions:

WALANT for olecranon fracture fixation avoids the need for tourniquets, general anesthesia, and heavy sedation.
The technique allows for immediate assessment of fracture stability through active motion.
This method presents a safe, cost-effective, and reproducible option for select patient groups.