Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study

How, Hui Meng; Khoo, Brandon Liu Juan; Ayeop, Mohd Adham Shah; Ahmad, Abdul Rauf; Bahaudin, Norhaslinda; Ahmad, Amir Adham

doi:10.1016/j.jhsg.2022.02.004

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…Every year, new reports that push boundaries are published. There are recent reports of wrist surgery, radius, and ulna fracture plating, elbow surgery, clavicle plating, and major limb amputations (71,72,73,74,75,76,77,78,79,80). Although the cost benefits of this approach in these cases are evident, the absolute indications for these procedures are not yet completely clear and are still limited to preferences or circumstances outruling other options (66,81,82,83).…”

Section: Future Prospectsmentioning

confidence: 99%

WALANT surgery of the hand: state of the art

Degreef,

Lalonde

2024

EFORT Open Reviews

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Wide-awake local anesthesia no tourniquet is named the WALANT technique. WALANT has had a major positive impact on cost, convenience, ecology, patient satisfaction, access to surgical care, and outcomes in hand surgery in the last 20 years. Safe and efficient application of the technique is based on two principles. The first principle is the tumescent injection of a large volume low concentration 0.25–1% lidocaine, with 1:100 000–1:400 000 epinephrine. The second principle of WALANT is that the proper injection should be almost painless, with the patient only feeling the first needle poke of a tiny 30G needle. This wide awake patient approach reduces pain, neuropraxia, and systemic side effects of sedation with preservation of motor control, thereby aiding balanced reconstruction in hand surgery.

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Section: Future Prospectsmentioning

confidence: 99%

WALANT surgery of the hand: state of the art

Degreef,

Lalonde

2024

EFORT Open Reviews

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“…Recent reports from around the globe have documented successful open reduction and plate fixation of distal radius fractures, further expanding utility of the WALANT technique [14][15][16][17] . Even plating of diaphyseal forearm fractures has been shown to be feasible 18 .…”

Section: Advantages Of the Walant Technique Broad Application In Hand...mentioning

confidence: 99%

Adoption of the Wide-Awake Local Anesthesia No Tourniquet Technique in Hand Surgery

2023

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» Wide-awake local anesthesia no tourniquet (WALANT) technique featuring tumescent infiltration of lidocaine with epinephrine at the operative site has broad application in hand surgery including both soft-tissue and bone procedures.» The advantages of wide-awake anesthesia include high patient satisfaction, preserved intraoperative finger and wrist motion, cost-effectiveness, improved operating room efficiency, fewer opioids during recovery, and improved access to hand surgery, which may be performed in an office-based setting without the need for anesthesia personnel.» In properly selected patients, use of lidocaine with epinephrine in the hand and fingers is safe. Rare postprocedure digital ischemia may be effectively treated with phentolamine rescue.» Barriers to adopting wide-awake anesthesia may be overcome by educating resistant stakeholders, including hospital administrators, nurse leaders, and anesthesia colleagues, about the advantages of the WALANT method.» The risk of postoperative complications after hand procedures may be mitigated by using the wide-awake technique instead of regional anesthesia with sedation or general anesthesia.

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