gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Outcomes of Thirty cases treating with relative motion splint for zone 4-7 extensor tendon injury with wide awake local anesthesia and without tourniquet surgery (WALANT)

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  • presenting/speaker Peggy Marque - Centre de la main, HP Saint-Martin, Caen, France
  • Gilles Candelier - Centre de la main, HP Saint-Martin, Caen, France
  • Thomas Apard - Centre de la main, Versailles, France
  • Donald Lalonde - Division of plastic surgery, Saint John, Canada

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1297

doi: 10.3205/19ifssh1578, urn:nbn:de:0183-19ifssh15783

Published: February 6, 2020

© 2020 Marque et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: The development of wide awake local anesthesia (WALANT) to extensor tendon repair allows hand surgeons and therapists to check immediate post operative active motion of a freshly repaired tendon before closing the wound. During the surgery, they can also adapt treatments plans by the pencil test for the application of the relative motion splint.

Clinical reasoning: The aim of this study is to evaluate the outcome of our post operative protocole of the relative motion splint after zone 4-7 extensor tendon repair walant.

Methods: From January 2016 to December 2017, they were thirty cases of extensor tendons repairs (30 patients - 35 tendons) under walant and a relative motion splint allowing early mobility after the surgery. All adults patients (17 years old to 73 - mean 39 years old) who had one or two extensor tendons repaired in zone 4-7 (24 tendons in zone 5 - 6 tendons in zone 6) under WALANT were seen by the therapist 7 days after the surgery for the relative motion splint's realization. Removal of the brace was assessed at 6 weeks post operative. We noted at 6 weeks follow-up the rate of satisfation of the brace (0: unsatisfied, 10 very satified), and the quality of the scare.

Results: In our cohort, no patients presented extensor tendon rupture, infection, complex regional pain syndrome or pathological scare.

Patients obtained a full range of motion of the fingers without any physiotherapy prescription. The satisfaction rate with the orthosis was 8,6 /10 (0: unsatisified, 10 very satisfied).

Conclusion: The WALANT technique permitted to use the pencil test during the surgery and so a relative motion splint protocole.