Key result
WALANT technique enables painless distal radius osteosynthesis in a 90-year-old with severe comorbidities.
Why the study?
Surgical fixation of distal radius fractures under local anesthesia without tourniquet allows intraoperative testing and avoids adverse effects of general anesthesia in elderly patients with comorbidities.
Case Report (n=1)
No
The WALANT technique allows elderly patients with extensive comorbidities to undergo surgical fixation of distal radius fractures while avoiding adverse effects of general anesthesia or axillary blocks.
Hypothesis-generating for WALANT in frail elderly; prospective trials needed before clinical adoption.
Distal radius fractures are the most common fractures of the upper limb. It is a common fracture in the elderly and the indiction of an osteosynthesis by locked plate is often posed in view of the osteopenia. Surgical fixation of distal radius fractures under local anesthesia with the patient wide awake without a tourniquet allows intraoperative testing of fixation stability under active mobilization. This technique allows elderly people with extensive comorbidities to avoid the adverse effects commonly associated with general anesthesia or axillary blocks. The WALANT anesthesia technique (awake local anesthesia without tourniquet) consists of an injection of a local anesthetic of lidocaine and epinephrine into the operating field and without the use of a tourniquet. This article reports the detailed management under WALANT of osteosynthesis of the distal radius in an elderly patient presenting with extensive comorbidities.
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Ousmane et al. (2022) conducted a case report in Distal radius fracture (n=1). WALANT (Wide-Awake Local Anesthesia No Tourniquet) was evaluated on Intraoperative pain assessed by Visual Analog Scale (VAS). The WALANT technique enabled successful and painless plate osteosynthesis of a distal radius fracture in a 90-year-old female with severe comorbidities, maintaining a pain score of zero throughout the procedure.
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