Wide-Awake Anesthesia for Olecranon Fracture Fixation

Abstract

Introduction: Wide-awake local anesthesia and no tourniquet (WALANT) has come a long way. It has been reported to be successful in the surgery of distal radius and ulna fractures. We report a case of olecranon fracture plating under WALANT. Methods: Surgery was performed with the patient fully conscious where tumescent anesthesia was injected into the surgical site without application of tourniquet 30 minutes before the first incision. Posterior approach to the elbow was used, and the fracture was fixed with anatomical locking plates. Results: The surgery was successfully completed without pain. The numerical pain rating score was 0 throughout the surgery. Conclusions: The use of WALANT for surgical fixation can be expanded beyond the hand and wrist. This is a safe and simple option for patients at high risk of general anesthesia, producing similar surgical outcomes without intraoperative and postoperative complications.

Wide-awake local anesthesia for clavicle fracture fixation: A case report

“…Moreover, the WALANT technique can be used in patients who are at a risk of adverse effects from general anesthesia. This technique has been used in various operations in orthopedic surgery, such as distal radius fracture, ulnar shaft fracture, and olecranon fracture [ [2] , [3] , [4] , [5] ]. However, its use has not yet been reported in a mid-shaft clavicular fracture.…”

“…Wide-awake local anesthesia no tourniquet (WALANT) has been widely used in orthopedic surgery [ [2] , [3] , [4] , [5] ]. However, there have been no reports of its use in clavicular surgery.…”

Important updates of finger fractures, entrapment neuropathies and wide-awake surgery of the upper extremity

“…Large volumes of tumescent anaesthesia can be injected circumferentially around long bones such as the radius to allow for painless manipulation and plating (Figure 6) (Ahmad et al, 2018(Ahmad et al, , 2020(Ahmad et al, , 2021Huang et al, 2018;Orbach et al, 2018;Tahir et al, 2020). Surgeons are applying WALANT to volar plate and/ or fragment specific fixation of distal radius, both bone forearm, olecranon and clavicle fractures and radioscapholunate arthrodesis (Figure 7) (Online Supplementary Figure S1) (Ahmad et al, 2018(Ahmad et al, , 2020(Ahmad et al, , 2021Huang et al, 2018;Kurtzman et al, 2021;Orbach et al, 2018;Tahir et al, 2020). One of the authors (SK) routinely performs distal radius fracture fixation under WALANT using field sterility (Kurtzman et al, 2021).…”

Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy

“…Bony fixation of the distal radius, mid-shaft ulna, and olecranon has been reported by Ahmad and Ikram 6 and Ahmad et al, 7 , 8 but there is still a very little account on proximal forearm WALANT tendon transfers. This article describes, with illustrations and video, the Brand tendon transfer with WALANT for radial nerve palsy.…”