CURRENT CONCEPTS IN ADULTS UPPER EXTREMITY FRACTURES

21452Ugur_TiftikciCurrent_Consept_in_adults.kapak

THE ROLE OF WALANTIN CERTAIN FRACTURES FROM HAND TO ELBOW

Uğur Bezirgan1 Yusuf Kıratlıoğlu2

1Ankara University, Faculty of Medicine, Department of Hand Surgery, Ankara, Türkiye
2Ankara University, Faculty of Medicine, Department of Hand Surgery, Ankara, Türkiye

Bezirgan U, Kıratlıoğlu Y. The Role of WALANT in Certain Fractures from Hand to Elbow. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.423-431.

ABSTRACT

Wide Awake Local Anesthesia with No Tourniquet (WALANT) has emerged as a revolutionary approach in the treatment of fractures. While it is most commonly used for phalangeal and metacarpal fractures, its use is also increasing in the treatment of scaphoid, distal radius, forearm fractures, and elbow fractures. This technique, which uses a special local anesthetic mixture consisting of epinephrine, lidocaine, sodium bicarbonate, and isotonic solution, provides effective analgesia, hemostasis, and improved surgical visibility without the need for a tourniquet. During surgery, it allows for the evaluation of rotation, stability, and tendon tension, facilitating functional assessments. The advantages of this method include reduced postoperative pain, cost-effectiveness, and avoidance of general anesthesia, making it particularly suitable for elderly or high-risk patients. However, careful consideration of contraindications, such as vascular insufficiencies or lidocaine allergies, is important. This review emphasizes the significant role of WALANT in orthopedic surgery, providing information on its preparation, injection techniques, applications, and potential limitations.

Keywords: Anesthesia local; Scaphoid bone; Radius fractures; Wrist; Metacarpal bones; Elbow joint

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