Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy
Summary:. Tendon transfer for radial nerve palsy is a common procedure done under general anesthesia. We describe a surgical technique of triple tendon transfer with wide awake local anesthesia no tourniquet (WALANT). We transfer flexor carpi radialis to extensor digitorum communis, palmaris longus...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2020-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003023 |
| _version_ | 1818112608484458496 |
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| author | Shalimar Abdullah, BMBS, BMedSci, MS(Ortho) Amir Adham Ahmad, MBBS, MS(Ortho) Donald Lalonde, MD, MSc, FRCSC |
| author_facet | Shalimar Abdullah, BMBS, BMedSci, MS(Ortho) Amir Adham Ahmad, MBBS, MS(Ortho) Donald Lalonde, MD, MSc, FRCSC |
| author_sort | Shalimar Abdullah, BMBS, BMedSci, MS(Ortho) |
| collection | DOAJ |
| description | Summary:. Tendon transfer for radial nerve palsy is a common procedure done under general anesthesia. We describe a surgical technique of triple tendon transfer with wide awake local anesthesia no tourniquet (WALANT). We transfer flexor carpi radialis to extensor digitorum communis, palmaris longus to extensor pollicis longus, and pronator teres to extensor carpi radialis brevis. This is commonly known as the Brand transfer. Our anesthetic or WALANT solution consists of up to 200 mL of 1:400,000 epinephrine, 0.25% lidocaine buffered with sodium bicarbonate. This technique overcomes the problem of judging the appropriate amount of transfer tension by observing awake patients actively extend their fingers, thumb, and wrist during the surgery and making adjustments before we close the wound. In our experience, there is no need of brain retraining because a patient is able to immediately use the flexor muscles to perform extension movements. WALANT is a safe and viable option for radial nerve tendon transfers. |
| first_indexed | 2024-12-11T03:21:39Z |
| format | Article |
| id | doaj.art-69c14a8c486940338dde375368d048e1 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-11T03:21:39Z |
| publishDate | 2020-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-69c14a8c486940338dde375368d048e12022-12-22T01:22:37ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742020-08-0188e302310.1097/GOX.0000000000003023202008000-00023Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve PalsyShalimar Abdullah, BMBS, BMedSci, MS(Ortho)0Amir Adham Ahmad, MBBS, MS(Ortho)1Donald Lalonde, MD, MSc, FRCSC2From the * Hand and Microsurgery Unit, Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia† Department of Orthopaedics, Prince Court Medical Centre, Kuala Lumpur, Malaysia‡ Department of Plastic and Reconstructive Surgery, Dalhousie University, Saint John, New Brunswick, Canada.Summary:. Tendon transfer for radial nerve palsy is a common procedure done under general anesthesia. We describe a surgical technique of triple tendon transfer with wide awake local anesthesia no tourniquet (WALANT). We transfer flexor carpi radialis to extensor digitorum communis, palmaris longus to extensor pollicis longus, and pronator teres to extensor carpi radialis brevis. This is commonly known as the Brand transfer. Our anesthetic or WALANT solution consists of up to 200 mL of 1:400,000 epinephrine, 0.25% lidocaine buffered with sodium bicarbonate. This technique overcomes the problem of judging the appropriate amount of transfer tension by observing awake patients actively extend their fingers, thumb, and wrist during the surgery and making adjustments before we close the wound. In our experience, there is no need of brain retraining because a patient is able to immediately use the flexor muscles to perform extension movements. WALANT is a safe and viable option for radial nerve tendon transfers.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003023 |
| spellingShingle | Shalimar Abdullah, BMBS, BMedSci, MS(Ortho) Amir Adham Ahmad, MBBS, MS(Ortho) Donald Lalonde, MD, MSc, FRCSC Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy Plastic and Reconstructive Surgery, Global Open |
| title | Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy |
| title_full | Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy |
| title_fullStr | Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy |
| title_full_unstemmed | Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy |
| title_short | Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy |
| title_sort | wide awake local anesthesia no tourniquet forearm triple tendon transfer in radial nerve palsy |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003023 |
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