局解手术学杂志2025，Vol.34Issue(9)：836-839,4.DOI:10.11659/jjssx.11E024126
全清醒无止血带局部麻醉技术在伸直受限型掌指关节交锁手术中的应用
Application of wide awake local anesthesia no tourniquet technique in locking of metacarpophalangeal joint with extension lag surgery
杨国涛 1毛华杰 1陈志军 1张旭 1胡焕 1江起庭2
作者信息
- 1. 丹阳市人民医院骨科,江苏 丹阳 212300
- 2. 南京江北医院手足显微外科,江苏 南京 210048
- 折叠
摘要
Abstract
Objective To explore the application value of wide awake local anesthesia no tourniquet(WALANT)technique in outpatient surgery for locking of metacarpophalangeal joint with extension lag.Methods The clinical data of 6 patients with locking of meta-carpophalangeal joint with extension lag in Danyang People's Hospital from January 2019 to October 2023 were retrospectively analyzed.The patients were received outpatient surgery under the WALLANT technique for release,and lidocaine mixed solution containing 1∶100 000 epinephrine was injected into the proximal midpoint of the volar projection of the metacarpophalangeal joint.The joint was exposed with a volar or dorsal finger web incision to determine the unrestricted structure,and the collateral ligament and paralateral collateral ligament with high tension were cut off.The intraoperative blood loss,postoperative incision healing and complications were recorded.Visual analogue scale(VAS)was used to evaluate the intraoperative pain,and the range of motion of metacarpophalangeal joint and total active movement(TAM)of finger joint were observed during postoperative follow-up.Results The incision of patients were healed successfully in the first phase after surgery,without wound necrosis.The anesthesia effects of patients were all satisfied and the operation was successfully completed.The VAS score was less than 3 points and there was only a small amount of bleeding during the operation.The recovery of joint flexion and extension movements could be observed during the operation,and the TAM score after the operation was 20 points.No significant change was found on the range of motion of metacarpophalangeal joint or TAM of finger joint between the injured finger and the corresponding healthy finger(P>0.05).Conclusion WALANT technique for locking of metacarpophalangeal joint with extension lag surgery has good anesthesia effect,less bleeding in the incision,and clear vision of the surgery.It can avoid vascular and nerve injuries,observe the recovery of joint activities during the operation and relieve pain of patients,which is conducive to outpatient surgery and saving medical and social resources at the same time.关键词
外科手术/麻醉/掌指关节交锁/全清醒无止血带局部麻醉/肾上腺素Key words
surgery/anesthesia/locking of metacarpophalangeal joint/wide awake local anesthesia no tourniquet/epinephrine分类
医药卫生引用本文复制引用
杨国涛,毛华杰,陈志军,张旭,胡焕,江起庭..全清醒无止血带局部麻醉技术在伸直受限型掌指关节交锁手术中的应用[J].局解手术学杂志,2025,34(9):836-839,4.
