Wide-Awake Olecranon Fracture Fixation: Is it Possible?

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.