Wide-Awake Hemi-hamate Arthroplasty for Chronic PIPJ Fracture-Dislocation: A Case Report

Wide-awake local anaesthesia, no tourniquet (WALANT) has been reported for upper extremity procedures of varying complexities ranging from simple tendon repairs to more complicated soft tissue and bony reconstructions. Hemi-hamate arthroplasty under WALANT has yet to be described in English literature. We report a case of a chronic dorsal PIPJ fracture-dislocation who underwent open reduction followed by Hemi-hamate Arthroplasty under wide-awake anaesthesia. There was adequate visualization during the surgery with no additional anaesthesia required. Active intra-operative range of motion and joint stability testing was possible with no pain experienced throughout the procedure. 10-month post-operative follow-up showed excellent range of motion with occasional tolerable pain during maximal finger flexion and power grip. Wide-awake anaesthesia is a viable and safe alternative for hemi-hamate arthroplasty.