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Eur J Trauma Emerg Surg · Jul 2024
ReviewThe wide-awake local anesthesia no tourniquet (WALANT) technique in thumb injuries: a systematic review.
- Maria do Rosario Saraiva, Olalla Saiz Vázquez, Juan Hilario Ortiz-Huerta, and Montserrat Santamaría-Vázquez.
- School of Health Sciences of Polytechnic of Leiria, Campus 2 - Morro Do Lena, Alto Do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal.
- Eur J Trauma Emerg Surg. 2024 Jul 5.
UnlabelledHuman hands have a complex anatomical structure. The thumb, being an integral part of the hand, has an essential function in gripping. In this sense, thumb fractures account for 4% of all hand fractures (it may occur in association with fractures of the trapezium). The majority of hand fractures should be treated non-surgically and surgeons must avoid unnecessary surgery. Historically, hand surgery has used a combination of local/regional/general anaesthesia and a tourniquet. This study aims to carry out a systematic review to determine whether the WALANT technique is an advantageous alternative to conventional anaesthesia for surgical procedures on thumb injuries, in terms of patient function and pain.MethodWe conducted a search in the following databases: Pubmed/Medline, EBSCOhost, Web of Science, Scopus, ScienceDirect and Google Scholar, using the equation "WALANT" OR "Wide Awake Local Anesthesia No Tourniquet" AND "thumb pathology".ResultsIn five of the 584 articles included, two studied trapeziometacarpal osteoarthritis, one De Quervain's disease and the remaining two flexor injuries. WALANT showed good results in active movements, but with similar levels of pain between anaesthetics. Patients were more anxious during general anaesthesia, plus the fact that they were fasting and suspending medication.ConclusionWALANT is a convenient and favourable option in several studies. It has been demonstrated the benefits in terms of return to function and pain.© 2024. The Author(s).
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