Skip to main content
SpringerLink
Log in

WALANT for Adult Hand Fractures

  • Chapter
  • First Online:
Pediatric and Adult Hand Fractures

  • 245 Accesses

Abstract

WALANT hand fracture reduction has increased rapidly in popularity in the last 10 years because it offers a lot of advantages: (1) Increased safety in patients with severe medical comorbidities, (2) Decreased cost and trash production, (3) The ability to move hand fractures out of the main operating room to increase surgeon and patient convenience, (4) Increased patient convenience and comfort with elimination of nausea and vomiting, (5) Patients can tell you if their fingers are no longer crooked after reduction during the surgery, (6) You can test the stability of K wire fixation with patient intraoperative full fist flexion and extension testing to allow early protected movement like after flexor tendon repair so the tendons don’t get stuck in scar, (7) Surgeons can educate patients in an uninterrupted fashion during local anesthesia and surgery time to decrease the risk of post-operative complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gillis JA, Williams JG. Cost analysis of percutaneous fixation of hand fractures in the main operating room versus the ambulatory setting. J Plast Reconstr Aesthet Surg. 2017;70(8):1044–50.

    Article  PubMed  Google Scholar 

  2. Gillis JA, Lalonde J, Alagar D, Azzi A, Lalonde DH. K-wire Fixation of Closed Hand Fractures Outside the Main Operating Room Does Not Increase Infections. Plast Reconstr Surg Glob Open. 2022 Nov 21;10(11):e4679. https://doi.org/10.1097/GOX.0000000000004679. PMID: 36438460; PMCID: PMC9682614.

  3. Yu J, Ji TA, Craig M, McKee D, Lalonde DH. Evidence-based sterility: the evolving role of field sterility in skin and minor hand surgery. Plast Reconstr Surg Glob Open. 2019;7(11):e2481.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Steve AK, Schrag CH, Kuo A, Harrop AR. Metacarpal fracture fixation in a minor surgery setting versus main operating room: a cost-minimization analysis. Plast Reconstr Surg Glob Open. 2019;7(7):e2298.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Garon MT, Massey P, Chen A, Carroll T, Nelson BG, Hollister AM. Cost and complications of percutaneous fixation of hand fractures in a procedure room versus the operating room. Hand. 2018;13(4):428–34.

    Article  PubMed  Google Scholar 

  6. Lalonde DH. How to inject local anesthesia with minimal pain. In: Lalonde DH, editor. Wide awake hand surgery. New York, NY: Thieme; 2016. p. 37–48.

    Google Scholar 

  7. YouTube. Lecture on how to inject local anesthesia with minimal pain for hand fractures. n.d.. https://youtu.be/IcSizvzD6LM. Accessed 26 Jun 2021.

  8. McKee DE, Lalonde DH, Thoma A, et al. Optimal time delay between epinephrine injection and incision to minimize bleeding. Plast Reconstr Surg. 2013;131:811–4.

    Article  CAS  PubMed  Google Scholar 

  9. Greene B, Lalonde D, Seal S. Incidence of the “adrenaline rush” and vasovagal response with local anesthetic injection. Plast Reconstruct Surg Glob Open. 2021;9(6):e3659.

    Article  Google Scholar 

  10. Lalonde DH. Finger fractures. In: Lalonde DH, editor. Wide awake hand surgery. New York, NY: Thieme; 2016. p. 237–42.

    Google Scholar 

  11. Xing SG, Tang JB, Lalonde DH. Metacarpal fractures. In: Lalonde DH, editor. Wide awake hand surgery. New York, NY: Thieme; 2016. p. 243–6.

    Google Scholar 

  12. Lalonde DH, Amadio PC, Cook G. Trapeziectomy with or without ligament reconstruction. In: Lalonde DH, editor. Wide awake hand surgery. New York, NY: Thieme; 2016. p. 165–9.

    Google Scholar 

  13. Kurtzman JS, Etcheson JI, Koehler SM. Wide-awake local anesthesia with no tourniquet: an updated review. Plast Reconstr Surg Glob Open. 2021;9(3):e3507.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Abd Hamid MH, Abdullah S, Ahmad AA, Narin Singh PSG, Soh EZF, Liu CY, Sapuan J. A randomized controlled trial comparing wide-awake local anesthesia with no tourniquet (WALANT) to general anesthesia in plating of distal radius fractures with pain and anxiety level perception. Cureus. 2021;13(1):e12876.

    PubMed  PubMed Central  Google Scholar 

  15. Gregory S, Lalonde DH, Fung Leung LT. Minimally invasive finger fracture management: wide-awake closed reduction, K-wire fixation, and early protected movement. Hand Clin. 2014;30(1):7–15.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Plastic Surgery, Dalhousie University, Saint John, NB, Canada

    Donald H. Lalonde

Authors
  1. Donald H. Lalonde
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Donald H. Lalonde .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA

    Joshua M. Abzug

  2. Atrium Health Carolinas Medical Center, Charlotte, NC, USA

    R. Glenn Gaston

  3. Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    A. Lee Osterman

  4. Rothman Orthopaedic Institute Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA

    Richard J. Tosti

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lalonde, D.H. (2023). WALANT for Adult Hand Fractures. In: Abzug, J.M., Gaston, R.G., Osterman, A.L., Tosti, R.J. (eds) Pediatric and Adult Hand Fractures. Springer, Cham. https://doi.org/10.1007/978-3-031-32072-9_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-32072-9_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-32071-2

  • Online ISBN: 978-3-031-32072-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation