Wide-awake local anesthesia with no tourniquet as effective as balanced anaesthesia for DRF plating surgery

Distal radius fracture (DRF) is a common injury that can require surgical intervention. The use of wide-awake local anesthesia with no tourniquet (WALANT) has been investigated in several studies for DRFs. Despite WALANT being suitable for all cases of DRF surgeries is still being determined for its detrimental effects.

Chih-Ting Chen and team in the study aimed to evaluate the functional outcomes, complications, and patient-reported outcomes of DRF plating surgery under both the WALANT and balanced anesthesia (BA). The study found that with preoperative planning WALANT technique could be an alternative for DRF plating surgery in selected patients. They found there was reduction quality, functional outcomes, and overall satisfaction were comparable between the WALANT and BA groups. The study findings are published in Journal of Orthopaedic Surgery and Research.

A total of 93 patients with DRFs who underwent open reduction and plating were included. Regarding the anesthetic technique, 38 patients received WALANT, while 55 received BA, comprised of multimodal pain control brachial plexus anesthesia with light general support. The patient's overall satisfaction in both groups and the intraoperative numerical rating scale of pain and anxiety (0–10) in the WALANT group were recorded. The peri-operative radiographic parameters were measured; the clinical outcomes, including Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, wrist mobility, and grip strength, were recorded in up to 1-year follow-up. Results presented with a mean difference and 95% confidence intervals and mean ± standard deviation.