The Thumb pp 199-211 | Cite as

Wide-Awake Tendon Surgery

  • Myung Jae Yoo
  • Sang Hyun Woo


This chapter provides description of the technical details of how to inject local anesthesia for wide-awake tendon surgery of the thumb. We demonstrate how to perform primary tendon repair of both flexor and extensor pollicis longus as well as tenolysis. In cases of nerve palsy or chronic rupture of tendons, delayed reconstruction of the extensor and flexor tendons under wide-awake anesthesia is described. Although there are many advantages of the original wide-awake anesthesia, we introduce some modifications according to the unique national insurance system and doctors’ preferences.


Wide-awake tendon repair Tenolysis Tendon transfer Thumb 

Supplementary material

Video 12.1

Preoperative patients and local anesthetic injection. It shows details of how to inject local anesthesia for wide-awake surgery (WMV 223076 kb)

Video 12.2

Delayed flexor pollicis longus (FPL) repair with pulley reconstruction. It shows details of how to repair flexor pollicis longus (FPL) and reconstruct A1 pulley under wide-awake anesthesia (WMV 126 kb)

Video 12.3

Flexor pollicis longus (FPL) tenolysis after tendon repair. It shows details of how to do flexor pollicis longus (FPL) tenolysis under wide-awake anesthesia (WMV 525373 kb)

Video 12.4

Extensor indicis proprius (EIP) to extensor pollicis longus (EPL) tendon transfer. It shows details of how to do tendon transfer under wide-awake anesthesia (WMV 804584 kb)

Video 12.5

Flexor digitorum superficialis (FDS) of the long or ring finger to flexor pollicis longus (FPL) tendon transfer. It shows details of how to do tendon transfer under wide-awake anesthesia (WMV 172599 kb)


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Myung Jae Yoo
    • 1
  • Sang Hyun Woo
    • 1
  1. 1.W Institute for Hand and Reconstructive Microsurgery, W HospitalDaeguSouth Korea

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