Pedicled Anconeus Flap for Posterior Elbow Reconstruction Using WALANT: A Case Report

The wide-awake local anesthesia no tourniquet (WALANT) technique has become increasingly popular in hand and upper extremity procedures due to its cost-effectiveness, safety, and a high level of patient satisfaction. Though it has been described in various flap surgeries, its use in a pedicled anconeus flap has not been reported. This procedure was performed on a 94-year-old woman who presented with a posterior elbow wound and impending hardware exposure three weeks following surgical fixation for an olecranon fracture. The procedure was performed using WALANT, and intraoperative active and passive motion was performed to confirm tension-free closure. The patient healed without flap compromise, infection, or wound dehiscence. Current successful patient outcomes, logistic benefits, and positive safety reports support the consideration of WALANT in other areas outside hand and upper extremity procedures.