Wide Awake Local Anesthesia No Tourniquet Technique for Extensor Indicis Proprius Tendon Transfer

Purpose: To evaluate the usefulness of the Wide Awake Local Anesthesia No Tourniquet (WALANT) technique for extensor indicis proprius (EIP) tendon transfer. Methods: From January 2014 to January 2016. We selected the patients with chronic extensor pollicis longus rupture who underwent EIP transfer surgery with WALANT. We evaluated the patient’s postoperative pain using visual analogue scale (VAS) scores, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and measured the range of motion (ROM) of the affected hand at the final follow-up session. And we compared total cost between WALANT operation and ordinary regional anesthesia. Results: There were 12 patients (4 males, 8 females) with a mean age of 57.1 years. The postoperative mean VAS score was 1.25. The mean DASH score was 17.4. The mean Metacarpophalangeal joint ROM was 56.9°, interphalangeal joint ROM was flexion 81°, extension 7.1°, and mean pinch power was 91% of unaffected side. Mean grip strength was 91% of unaffected side. Conclusion: Wide-awake approach has allowed the surgeon to know how much tendon tension on tendon repair site and tendon transfer site. The wide-awake approach makes surgeon do tendon surgery much easier and more reliable.