Podium (General) 12

Radial Shaft Fixation under Wide Awake Local Anesthesia No Tourniquet A Multicenter Retrospective Case Series

Juan Teofilo Antonio B. Abejo, MD
Raymar L. Sibonga, MD, FPOA
DLSUMC

Background The wide-awake local anesthesia no tourniquet (WALANT) technique is applied on various soft tissue and bony surgeries of the upper extremity. We investigated the perioperative variables and clinical outcomes of open reduction and internal fixation (ORIF) for radial shaft fractures under WALANT.


Methods From January 1, 2020 to July 31, 2021, 8 consecutive patients from 3 institutions with radial shaft fractures were treated with ORIF via anterior approach using WALANT technique. Operative time, blood loss and post-operative VAS score prior to discharge were collected. Forearm and wrist range of motions, Fil- DASH scores; and time to union were evaluated during the scheduled follow up.


Results Eight patients were included in this study, 7 male and 1 female, with a mean age of 26 years old (16-46 years old). The mean surgical time was 70 min (55-90). Average blood loss recorded was 30cc (20 – 50cc). All patients reported a VAS score of 1/10 prior to discharge. All patients had radiographic signs of union at 8 weeks follow-up (6 – 8 weeks). Fil-DASH 3 months post-surgery was recorded and averaged 9.07 (2 – 24). All patients had active wrist and forearm range of motion restored to more than 80% of the contralateral extremity, except for 1 who had active wrist flexion of 77%. No complications were noted during the procedure and during subsequent follow ups.


Conclusions ORIF of radial shaft fracture is feasible under WALANT technique. Perioperative variables, VAS prior to discharge, functional outcome, wrist and forearm range of motion and time to union yielded excellent results.