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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Patella Fracture Fixation Via Wide Awake Local Anesthesia No Tourniquet (Walant) Technique
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Patella Fracture Fixation Via Wide Awake Local Anesthesia No Tourniquet (Walant) Technique

机译：髌骨骨折固定通过宽阔的清醒局部麻醉无止血带（瓦尔娃娃）技术

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Introduction: Fracture of the tibia are the most common long bone fracture, with an incidence greater than 75,000 per year in the US1. With the recent breakthrough of operation under WALANT (Wide Awake Local Anaesthesia No Tourniquet) technique. We reported a patient with midshaft tibia fracture who underwent plating under the WALANT technique Methodology: 18 yearold gentleman sustained a closed fracture of his left tibia after his motorbike skidded. He wascounselled for the surgery to be done under the wide-awake technique as we have limited operating theatre time for the case to be done under general/regional anaesthesia. Preoperatively, the WALANT solution is prepared using 50 cc lidocaine 2%, 1cc of epinephrine, 10cc of sodium bicarbonate 8.4% then dilute into 50 cc normal saline. Total of 50 cc WALANT solution was injected along the planned skin incision and at subperiosteum 30 minutes before operation started. Result: Pain score patient remain 0-3/10 during and after removal of backslab, throughout the surgery and postoperatively. The use of epinephrine for hemostasis provide good surgical field view since there is minimal bleeding. Postoperatively the anaesthesia effect lasted for 6 hour and was patient able to move the leg straight away without have to keep lying in bed for 6 hours after spinal or drowsiness from sedation. Conclusion: Plating of tibia under WALANT is a good alternative for patient who have financial difficulty, high risk operation under general anaesthesia, hospital which have limited slot for operation under general anaesthesia and etc. Additionally, the strength and stability of the plate can be assessed intraoperatively by asking the patient to actively move his limb. Reference: Praemer A, Furner S, Rice DP. Musculoskeletal Conditions in the United States. Park Ridge, IL: American Academy of Orthopaedic Surgeons; 1992.
机译：介绍：胫骨的骨折是最常见的长骨折，US1发病率大于每年75,000。随着近期运作的突破（广阔的清醒局部麻醉无止血带）技术。我们报告了患有胫骨胫骨骨折的患者，在Walant技术方法下接受电镀：18岁的绅士在他的摩托车滑雪后持续了他左胫骨的封闭式骨折。他在宽阔令人醒着的技术下才能进行手术，因为我们在一般/区域麻醉下进行了有限的操作剧院时间。术前，使用50cc利多卡因2％，1cc的肾上腺素，10cc的碳酸氢钠10cc，然后稀释成50cc甘然油。在操作开始前30分钟，沿着计划的皮肤切口和亚孢子瘤注入50个CC瓦尔糖溶液。结果：疼痛评分患者在整个手术和术后留下后拉布后和后留下0-3 / 10。肾上腺素用于止血提供良好的手术场景，因为出血很小。术后麻醉效果持续了6小时，患者能够直接移动腿，而无需在休息后脊柱或嗜睡后的6小时内躺在床上。结论：胫骨下的胫骨镀层是具有财务困难，全身麻醉下的高风险运作的患者的良好替代品，该医院在一般麻醉等中进行有限的槽等。另外，可以评估板的强度和稳定性通过要求患者积极地移动他的肢体来术语。参考：Praemer A，Filper S，米DP。美国肌肉骨骼条件。 Park Ridge，IL：美国骨科外科医生的美国学院; 1992年。

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