Wide Awake Hand Surgery and Therapy Tips, 2E

The definitive multimedia resource on wide awake hand surgery from renowned experts!

WALANT (Wide Awake Local Anesthesia No Tourniquet) eliminates the need for preoperative testing, sedation, intravenous insertion, and monitoring in upper and lower limb surgery. Coupled with minimal pain injection techniques using pure local anesthesia with lidocaine and epinephrine, this technique has significantly improved hand surgery for patients and surgeons in many ways. Wide Awake Hand Surgery and Therapy Tips, Second Edition, provides readers with the best and latest WALANT advances from Donald H. Lalonde and an impressive group of hand surgeons from 15 countries that have incorporated this groundbreaking technique into practice to benefit their patients. Each richly illustrated chapter encompasses evidence-based benefits, step-by-step guidance, patient education tips, detailed injection directions, surgery and therapy tips and tricks, postsurgical management, and related videos.

WALANT produces better outcomes in flexor and extensor tendon repair, tendon transfer, tenolysis, tendon grafts, and finger fracture surgery because unsedated patients can easily move reconstructed parts during surgery. This allows surgeons to make required adjustments and teach patients uninterrupted while they are awake. Eliminating sedation also decreases risks, increases patient safety, and reduces pain associated with intravenous insertion. Simple surgeries such as trigger finger and carpal tunnel release no longer require costly main operating rooms. Instead, they can be performed in minor procedure rooms with evidence-based sterility, resulting in lower costs and reduced waste.

New Features:

• A three times larger video library with more than 500 videos, most of which are new
• New chapters on upper and lower limb fracture plating of the wrist, forearm, elbow, acromion, clavicle, tibia, fibula, ankle, and foot
• More than eight hours of video education covering ultrasound hand diagnosis and ultrasoundguided surgery
• Innovative hand therapy techniques made possible by WALANT detailed under Therapy Tips
• The use of pencil test and relative motion splinting to resolve numerous hand problems
• New strategies to implement WALANT in hospitals

This must-have resource will help hand surgeons, hand therapists, and allied nurses prevent unnecessary costs and risks, reduce complications, and improve patient outcomes.

Section I Atlas of Tumescent Local Anesthesia Elbow, Forearm, Wrist, Hand, and Finger Injections
1 Finger Blocks and Atlas of Images of Tumescent Local Anesthetic Diffusion Anatomy
Section II General Principles of Wide Awake Hand Surgery
2 Advantages of WALANT for Patients, Surgeons, and Anesthesiologists
3 Safe Epinephrine in the Finger Means No Tourniquet
4 On Using Tumescent Local Anesthesia
5 How to Inject Local Anesthetic So It Does Not Hurt
6 Dealing with Systemic Adverse Reactions to Lidocaine and Epinephrine
7 Tips on Explaining WALANT to Patients Before Surgery
8 Teaching Patients and Residents During Surgery Decreases Complications
9 Tips on Good Local Anesthesia in Infants and Children
10 Moving Surgery Out of the Main Operating Room with Evidence Based Field Sterility
11 WALANT and Value in Healthcare: Improving Outcomes and Lowering Cost
12 WALANT and “The Why???: Administration, Anesthesiology, Nursing, and Payers
13 Performing Your First Cases With WALANT
14 How to Schedule Fifteen or More Hand Surgery Cases Per Day with One Nurse
15 Integrating Hand Therapists into WALANT
16 Minor Procedure Room Setup
Section III Details of How to Do WALANT and Therapy for the Upper Extremity
Part A Tendon Surgery: Tendon Decompression
17 Trigger Finger
18 De Quervain Release
Part B Tendon Surgery: Lacerated Tendons
19 Flexor Tendon Repair of the Finger
20 Flexor Tendon Repair of the Hand, Wrist, and Forearm
21 Extensor Tendon Repair of the Finger (Zone 1 Mallet to Zone 5 MP Joint)
22 Extensor Tendon Repair of the Hand, Wrist and Forearm (Zones 6 to 8)
Part C Tendon Surgery: Tenolysis
23 Tenolysis
Part D Tendon Surgery: Tendon Transfers
24 Tendon Transfers
Part E Tendon Surgery: Tendon Grafts and Pulley Reconstruction
25 Tendon Grafts and Pulley Reconstruction
Part F Nerve Surgery
26 Carpal Tunnel Decompression of the Median Nerve
27 Cubital Tunnel Decompression of the Ulnar Nerve
28 Lacertus Syndrome: Median Nerve Release at the Elbow
29 Radial and Peroneal Nerve Decompression
30 Simultaneous Release Carpal Tunnel with Cubital Tunnel or Lacertus
31 Lacerated Nerves
Part G Dupuytren, Mass Excision, Flaps, Compartment Syndrome Decompression, and Infection
Surgery
32 Dupuytren's Contracture
33 Ganglions and Other Small Soft Tissue Operations

34 Flap Harvest and Transfer in the Hand
35 Infection Surgery, Compartment Syndrome Release, Tibial Hematoma Drainage
Part H Joint and Arthritis Surgery: PIP and MP
36 Finger Joint Arthroplasty, Fusion and Ligament Repair
37 Thumb Metacarpophalangeal Joint Fusion and Ulnar Collateral Ligament Repair
Part I Joint and Arthritis Surgery: Wrist
38 Trapeziectomy With or Without Ligament Reconstruction for Thumb Basal Joint Arthritis
39 Wrist Arthroscopy
40 Wrist Arthritis Surgery
Part J Upper Limb Bones and Fracture Surgery
41 Finger Fractures
42 Metacarpal Fractures
43 Wrist Fracture and Ligament Surgery
44 Distal Radius and Forearm Fractures
45 Surgery about the Elbow
46 Clavicle and Acromion Fractures
Part K Amputation and Replantation
47 Finger and Ray Amputation
48 Replantation
Part L Ultrasound Diagnosis and Treatment in Hand Surgery
49 What You Need to Know about the Basics of Using Ultrasound for WALANT Hand Surgery
50 Ultrasound Assisted (USA) Upper Extremity Procedures
Section IV WALANT Lower Extremity Surgery
51 Patella Fractures
52 Tibia and Fibula Fractures
53 Foot and Ankle Fractures and Surgery
Section V Pencil Test and Relative Motion Splinting to Solve Hand Pain Problems and Improve Range
of Motion in Stiff Fingers
54 Pencil Test and Relative Motion Splinting to Solve Hand Pain and Stiffness After Trauma and Surgery