Ignacio Rellán, Agustín Guillermo Donndorff, Gerardo Luis Gallucci, Pedro Bronenberg Victorica, Fernando Holc, Mariano Abrego, Jorge Guillermo Boretto
{"title":"小切口WALANT技术治疗肘管综合征：手术技术及短期随访病例系列。","authors":"Ignacio Rellán, Agustín Guillermo Donndorff, Gerardo Luis Gallucci, Pedro Bronenberg Victorica, Fernando Holc, Mariano Abrego, Jorge Guillermo Boretto","doi":"10.1007/s43465-025-01362-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Wide-Awake Local Anesthesia No Tourniquet (WALANT) has expanded its applications over the past decade from common hand procedures to a broader range of more complex surgeries. However, despite its frequent use, there is limited literature on WALANT for cubital tunnel syndrome. We have adapted the endoscopic technique reported by other colleagues to a mini-open approach. This approach is characterized by a smaller incision while preserving its blood supply. Our objective is to describe this two-stage local anesthetic injection method that has enabled us to safely and successfully treat 16 patients without complications.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study. Sixteen patients meeting specific inclusion criteria underwent ulnar nerve decompression under WALANT. Patients were preoperatively classified according to Dellon's classification. Surgical technique included a staged local anesthetic solution infiltration and careful dissection to preserve nerve stability.</p><p><strong>Results: </strong>Preoperative classification revealed six mild, six moderate, and four severe cases. Intraoperative discomfort was reported by four patients before incorporating a second stage of distal local anesthetic infiltration. All patients exhibited stable intraoperative ulnar nerve positioning and were discharged independently 20 min post-surgery. Follow-up at an average of 12 weeks (range 10 -18 weeks) showed symptom resolution in all patients. No complications, including iatrogenic injury to medial antebrachial cutaneous nerve branches, were reported.</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility and effectiveness of the WALANT technique for ulnar nerve decompression at the elbow. Incorporating a staged local anesthetic infiltration enhances patient comfort.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-025-01362-0.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 5","pages":"659-666"},"PeriodicalIF":1.1000,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044119/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treatment of Cubital Tunnel Syndrome Under WALANT Technique Through a Mini-Open Approach: Surgical Technique and Case Series with Short-Term Follow-up.\",\"authors\":\"Ignacio Rellán, Agustín Guillermo Donndorff, Gerardo Luis Gallucci, Pedro Bronenberg Victorica, Fernando Holc, Mariano Abrego, Jorge Guillermo Boretto\",\"doi\":\"10.1007/s43465-025-01362-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Wide-Awake Local Anesthesia No Tourniquet (WALANT) has expanded its applications over the past decade from common hand procedures to a broader range of more complex surgeries. However, despite its frequent use, there is limited literature on WALANT for cubital tunnel syndrome. We have adapted the endoscopic technique reported by other colleagues to a mini-open approach. This approach is characterized by a smaller incision while preserving its blood supply. Our objective is to describe this two-stage local anesthetic injection method that has enabled us to safely and successfully treat 16 patients without complications.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study. Sixteen patients meeting specific inclusion criteria underwent ulnar nerve decompression under WALANT. Patients were preoperatively classified according to Dellon's classification. Surgical technique included a staged local anesthetic solution infiltration and careful dissection to preserve nerve stability.</p><p><strong>Results: </strong>Preoperative classification revealed six mild, six moderate, and four severe cases. Intraoperative discomfort was reported by four patients before incorporating a second stage of distal local anesthetic infiltration. All patients exhibited stable intraoperative ulnar nerve positioning and were discharged independently 20 min post-surgery. Follow-up at an average of 12 weeks (range 10 -18 weeks) showed symptom resolution in all patients. No complications, including iatrogenic injury to medial antebrachial cutaneous nerve branches, were reported.</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility and effectiveness of the WALANT technique for ulnar nerve decompression at the elbow. 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Treatment of Cubital Tunnel Syndrome Under WALANT Technique Through a Mini-Open Approach: Surgical Technique and Case Series with Short-Term Follow-up.
Introduction: Wide-Awake Local Anesthesia No Tourniquet (WALANT) has expanded its applications over the past decade from common hand procedures to a broader range of more complex surgeries. However, despite its frequent use, there is limited literature on WALANT for cubital tunnel syndrome. We have adapted the endoscopic technique reported by other colleagues to a mini-open approach. This approach is characterized by a smaller incision while preserving its blood supply. Our objective is to describe this two-stage local anesthetic injection method that has enabled us to safely and successfully treat 16 patients without complications.
Materials and methods: We conducted a retrospective cohort study. Sixteen patients meeting specific inclusion criteria underwent ulnar nerve decompression under WALANT. Patients were preoperatively classified according to Dellon's classification. Surgical technique included a staged local anesthetic solution infiltration and careful dissection to preserve nerve stability.
Results: Preoperative classification revealed six mild, six moderate, and four severe cases. Intraoperative discomfort was reported by four patients before incorporating a second stage of distal local anesthetic infiltration. All patients exhibited stable intraoperative ulnar nerve positioning and were discharged independently 20 min post-surgery. Follow-up at an average of 12 weeks (range 10 -18 weeks) showed symptom resolution in all patients. No complications, including iatrogenic injury to medial antebrachial cutaneous nerve branches, were reported.
Conclusion: This study demonstrates the feasibility and effectiveness of the WALANT technique for ulnar nerve decompression at the elbow. Incorporating a staged local anesthetic infiltration enhances patient comfort.
Supplementary information: The online version contains supplementary material available at 10.1007/s43465-025-01362-0.
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IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.
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