Displaying publications 21 - 22 of 22 in total

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  1. Plating of clavicle fracture using the wide-awake technique
    Ahmad AA, Ubaidah Mustapa Kamal MA, Ruslan SR, Abdullah S, Ahmad AR
    J Shoulder Elbow Surg, 2020 Nov;29(11):2319-2325.
    PMID: 32499198 DOI: 10.1016/j.jse.2020.03.003
    BACKGROUND: Fixation of clavicle fractures has now become a more popular option as it provides better outcome compared with conservative management. Wide-awake local anesthesia no tourniquet (WALANT) has been effectively used in plating of distal radius and olecranon fractures. This paper expands the usage of WALANT into the shoulder girdle, namely plating of the clavicle that has not been described. The operation is typically performed under general anesthesia.

    METHODS: We report a case series of 16 patients who successfully underwent fixation of the clavicle under the wide-awake technique. The clavicle fractures were grouped under the AO Fracture Classification. The WALANT solution comprised 1% lidocaine, 1:100,000 epinephrine, and 10:1 sodium bicarbonate. A total of 40 mL was injected in each patient with 10 mL subcutaneously along the clavicle followed by 30 mL subperiosteally at multiple intervals and directions.

    RESULTS: The Numerical Pain Rating Score was 0 during WALANT injection and during surgery except for 2 patients with Numerical Pain Rating Scores of 1 and 2, respectively, during reduction.

    CONCLUSION: We conclude that clavicle plating under WALANT is a good alternative option of anesthesia.

    Matched MeSH terms: Fracture Fixation, Internal/methods*
  2. Plating of Distal Radius Fracture Using the Wide-Awake Anesthesia Technique
    Ahmad AA, Yi LM, Ahmad AR
    J Hand Surg Am, 2018 Nov;43(11):1045.e1-1045.e5.
    PMID: 29866390 DOI: 10.1016/j.jhsa.2018.03.033
    Fractures of the distal radius are one of the most common types of injuries encountered in hand surgery. Plate osteosynthesis is recommended for unstable fractures. Because distal radius fracture fixation is usually performed under general or regional anesthesia with the use of a tourniquet, this exposes patients, especially elderly people with extensive comorbidities, to adverse effects commonly associated with these forms of anesthesia. As such, many of these patients are unable to undergo surgery in a timely manner until they are deemed medically fit for surgery or anesthesia, and some may still be treated nonsurgically. Injecting local anesthetic of lidocaine and epinephrine into the surgical field and without using a tourniquet is known to be advantageous for various surgical procedures of the hand. However, this approach, also known as wide-awake local anesthesia no tourniquet (WALANT), has not been used in the fixation of fractures beyond the wrist. Using the WALANT approach as an alternative anesthetic for plating of distal radius fractures may enable patients who are normally denied surgery owing to their age or medical comorbidities to undergo plate fixation for the fractures. This article outlines the WALANT approach used for a single case of fixation of distal end radius fracture with a detailed description of the technique of administering local anesthesia.
    Matched MeSH terms: Fracture Fixation, Internal/methods*
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