The effect of WALANT on outcomes of flexor tenolysis.

OBJECTIVES

This study aims to evaluate the outcomes of the flexor tenolysis cases with wide-awake local anesthesia no tourniquet (WALANT) and to compare them with cases with other anesthesia types.

PATIENTS AND

METHODS

Between March 2004 and March 2024, a total of 104 patients with 150 fingers with flexor tenolysis (71 males, 33 females; mean age: 32.67 ± 11.64 years; range, 16 to 62 years) were included in the study. The WALANT group consisted of 41 patients with 53 fingers, while the conventional anesthesia group consisted of 63 patients with 97 fingers. Pre- and postoperative total active motion (TAM) gains were compared between the two groups and relevant factors were investigated.

RESULTS

Overall TAM gain was 47% in our study cohort. The TAM gain was 55% and 43% in the WALANT group and in the conventional anesthesia group, indicating a statistically significant difference (p = 0.005). The best TAM gains were observed in the clean-cut injury type. The TAM gains were better in the cases without fractures. Age was a significant factor in the tenolysis outcomes, and younger patients had improved outcomes.

CONCLUSION

Our study results indicate a significant difference in the TAM gain between the WALANT and conventional methods. Taken together, we believe that the application of WALANT in tenolysis of flexor tendon adhesions represents a significant advancement in hand surgery. The ability to perform the procedure under local anesthesia while allowing for immediate assessment of tendon function enhances the surgical precision and results.