Internal fixation of metacarpal fractures using wide awake local anesthesia and no tourniquet

Feldman, Guy; Orbach, Hagay; Rinat, Barak; Rozen, Nimrod; Rubin, Guy

doi:10.1016/j.hansur.2020.01.003

Cited by 19 publications

(13 citation statements)

References 15 publications

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“…There was a reduction in the use of main operating theatres and increased use of minor operating theatres and clinic rooms. The available evidence suggests that outpatient operating is safe and does not increase the risk of infection 17 but it remains uncertain owing to a lack of high quality research. Recommendations have been produced on the minimum facilities required to carry out minor surgical procedures; a naturally ventilated room with easily cleaned surfaces and scrub-up facilities is sufficient 18 .…”

Section: Discussionmentioning

confidence: 99%

Adapting to the COVID-19 pandemic: A survey of UK and European hand surgery units

Shaw

Holmes

Jansen

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Discussionmentioning

confidence: 99%

Adapting to the COVID-19 pandemic: A survey of UK and European hand surgery units

Shaw

Holmes

Jansen

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…The preferred anaesthesia type for phalangeal and metacarpal fracture xation moved from general anaesthesia to regional. These would be the next procedures to be increasingly performed under WALANT and has been reported in the literature 16,17 .…”

Section: Discussionmentioning

confidence: 99%

Adapting to the COVID-19 pandemic: a survey of UK and European hand surgery units

Shaw

Holmes

Jansen

et al. 2021

Preprint

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Hand surgery services had to rapidly adapt to the coronavirus disease 2019 (COVID-19) pandemic. The aim of the Reconstructive Surgery Trials Network #RSTNCOVID hand surgery survey was to document the changes made in the United Kingdom and Europe and consider which might persist.A survey developed by the Reconstructive Surgery Trials Network, in association with the British Association of Hand Therapists, was distributed to hand surgery units across the UK and Europe after the first wave of COVID-19. It was completed by one consultant hand surgeon at each of the 44 units that responded.Adult and paediatric trauma was maintained but elective services stopped. Consultations were increasingly virtual and surgery was more likely to be under local anaesthetic and in a lower resource setting.Many of the changes are viewed as being beneficial. However, it is important to establish that they are clinically and cost effective. These survey results will help prioritise and support future research initiatives.

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“…Detailed tourniquet use is missing from the literature but is reported to be used in over 64% of procedures (Table 2). 34 Additionally, no specific evidence-based studies have been identified that compare different rehabilitation methods following metacarpal fracture treatment. In total, 23% of patients reported an incomplete range of motion following surgery; thus, studies to determine a specific rehabilitation protocol would be largely beneficial (Table 3).…”

Section: Tracermentioning

confidence: 99%

A Fourteen-year Review of Practice Patterns and Evidence-based Medicine in Operative Metacarpal Fracture Repair

Sasson

Shah

Yuksel

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background:The American Board of Plastic Surgery has been collecting practice data on metacarpal fracture operative repair since 2006 as part of its Continuous Certification process. These data allow plastic surgeons to compare their surgical experience to national trends. Additionally, these data present the opportunity to analyze those trends in relation to evidence-based medicine. Methods: Data on metacarpal fracture operative repair from May 2006 to December 2014 were reviewed and compared with those from January 2015 to March 2020. National practice trends observed in these data were evaluated and reviewed alongside published literature and evidence-based medicine. Results: In total, 1160 metacarpal fracture repair cases were included. Outpatient (as opposed to inpatient) operative repairs have been trending upward, from 50% to 61% (P < 0.001). Most repairs were performed under general anesthesia (68%), and there was a decrease in the use of regional anesthesia between our two cohorts (14%-9%; P = 0.01). An open reduction with internal fixation was the most popular technique (51%), and a decrease in the use of closed reduction with splinting was observed (16%-10%; P = 0.001). Stiffness was the most commonly reported adverse event. Topics addressed in evidence-based medicine articles but not tracer data included interosseous wiring, which has shown success in spiral shaft fracture treatment with minimal complications, and nonoperative management. Conclusion:As evidence-based recommendations continue to change with additional research inquiry, tracer data can provide an excellent overview of the current practice of metacarpal fracture repair and how effectively physicians adapt to remain aligned with best practices.

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Internal fixation of metacarpal fractures using wide awake local anesthesia and no tourniquet

Cited by 19 publications

References 15 publications

Adapting to the COVID-19 pandemic: A survey of UK and European hand surgery units

Adapting to the COVID-19 pandemic: A survey of UK and European hand surgery units

Adapting to the COVID-19 pandemic: a survey of UK and European hand surgery units

A Fourteen-year Review of Practice Patterns and Evidence-based Medicine in Operative Metacarpal Fracture Repair

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