Wide-awake Surgery for Congenital Thumb Flexion Anomaly in a Child

Abstract

Summary: We report a rare case of absent thumb IP joint flexion in bilateral thumbs due to anomalous tendon slips of the flexor pollicis longus. Cutting the anomalous insertions failed to improve active flexion of the IP joints. Successful treatment was achieved by evaluating the musculotendinous units of the original flexor pollicis longus and the anomalous flexor pollicis longus tendon during a wide-awake surgery.

Pediatric Wide-Awake Local Anesthesia No-Tourniquet Hand Surgery: A Practical Approach

“…There are few reports and case series of WALANT hand surgery in children within the literature. 5 , 6 This technique has also been described in Dr Lalonde’s 7 textbook with his personal approach to the pediatric patient. General anesthesia for children requiring procedures is accepted, particularly with a lack of evidence that it causes adverse neurodevelopmental effects.…”