WU Taoguang 1 , CHEN Hua 1 , NIE Shaobo 1 , ZHANG Wei 1 , WANG Ya 2 , TANG Peifu 1
  • 1. Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P. R. China;
  • 2. Department of Orthopedics, Guannan County People’s Hospital, Guannan Jiangsu, 222500, P. R. China;
TANG Peifu, Email: pftang301@163.com
Wide-awake local anesthesia no tourniquet technique; acute Achilles tendon rupture; channel-assisted minimally invasive repair; tourniquet
10.7507/1002-1892.202111086
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective  To explore the value of wide-awake local anesthesia no tourniquet (WALANT) technique in the treatment of acute Achilles tendon rupture. Methods In a prospective randomized controlled trial, 48 patients with acute Achilles tendon rupture who met the criteria between March 2020 and October 2020 were randomly divided into two groups according to 1∶1 distribution, with 24 cases in each group. The study group used WALANT technique and the control group used epidural anesthesia with tourniquet for channel-assisted minimally invasive repair (CAMIR). There was no significant difference between the two groups in gender, age, injured side, cause of injury, distance from broken end of Achilles tendon to calcaneal tubercle, and time from injury to hospitalization (P>0.05). The operating room use time (from patients entering the operating room to leaving the operating room), intraoperative blood loss, hospital stay, and the highest pain score [using Numerical Rating Scale (NRS)] during operation and at 1 day after operation were recorded and compared between the two groups. The tourniquet adverse reactions in the control group were recorded. The functional recovery was evaluated by the scoring method of American Orthopedic Foot and Ankle Society (AOFAS) at 12 months after operation. Results The operation was successfully completed in both groups. The operating room use time and hospital stay in the study group were significantly less than those in the control group (P<0.05), but the difference in the intraoperative blood loss between the two groups was not significant (t=0.429, P=0.670). There was no significant difference in the highest NRS score during operation between the two groups (t=1.671, P=0.101); the highest NRS score in the study group at 1 day after operation was significantly lower than that in the control group (t=−6.384, P<0.001). In the control group, 13 patients had different degrees of tourniquet adverse reactions, including tourniquet regional pain, local swelling, blisters, thigh numbness, and discomfort. The patients in both groups were followed up 12-18 months, with an average of 13.9 months. The motor function of all patients returned to normal at 12 months after operation. The difference in AOFAS scores between the two groups was not significant (t=0.345, P=0.731). There was no complication such as sural nerve injury, local infection, and secondary rupture in both groups. Conclusion The application of WALANT combined with CAMIR technique in the treatment of acute Achilles tendon rupture has good anesthetic and effectiveness, avoids the adverse reactions of tourniquet, and reasonably saves social medical resources.

Citation： WU Taoguang, CHEN Hua, NIE Shaobo, ZHANG Wei, WANG Ya, TANG Peifu. Application of wide-awake local anesthesia no tourniquet technique in the treatment of acute Achilles tendon rupture. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(3): 279-283. doi: 10.7507/1002-1892.202111086 Copy

  • Previous Article

    Comparison of locking plate and intramedullary nail in treatment of Neer two- and three-part fractures of the proximal humerus in the elderly

  • Next Article

    Analysis of influencing factors of early pain after arthroscopic rotator cuff repair