Application of wide awake local anesthesia no tourniquet technique in locking of metacarpophalangeal joint with extension lag surgery

YANG Guo-tao; MAO Hua-jie; CHEN Zhi-jun; ZHANG Xu; HU Huan; JIANG Qi-ting

doi:10.11659/jjssx.11E024126

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Application of wide awake local anesthesia no tourniquet technique in locking of metacarpophalangeal joint with extension lag surgery

Clinical Report | 更新时间：2025-09-24

- Application of wide awake local anesthesia no tourniquet technique in locking of metacarpophalangeal joint with extension lag surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 9, Pages: 836-839(2025)
- 作者机构：
  
  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
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.11E024126
  CLC： R686.5
- Received：23 November 2024，
  
  Published：25 September 2025
- 稿件说明：
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杨国涛,毛华杰,陈志军等.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(09):836-839.

YANG Guo-tao,MAO Hua-jie,CHEN Zhi-jun,et al.Application of wide awake local anesthesia no tourniquet technique in locking of metacarpophalangeal joint with extension lag surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):836-839.
杨国涛,毛华杰,陈志军等.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(09):836-839. DOI： 10.11659/jjssx.11E024126.

YANG Guo-tao,MAO Hua-jie,CHEN Zhi-jun,et al.Application of wide awake local anesthesia no tourniquet technique in locking of metacarpophalangeal joint with extension lag surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):836-839. DOI： 10.11659/jjssx.11E024126.

摘要

目的

探讨全清醒无止血带局部麻醉（WALANT）技术在伸直受限型掌指关节交锁门诊手术中的应用价值。

方法

回顾性分析2019年1月至2023年10月6例丹阳市人民医院收治的伸直受限型掌指关节交锁患者的临床资料，患者均在WALANT技术下行门诊手术松解，将含1∶100 000肾上腺素的利多卡因混合液注入掌指关节掌侧投影中点近端，掌侧或背侧指蹼切口暴露关节后探查有无限制结构，切断张力高的侧副韧带和副侧副韧带。记录术中出血量、术后切口愈合及并发症情况。采用视觉模拟量表（VAS）评估患者术中疼痛，术后随访期间观察患者掌指关节活动度及手指关节自主活动度（TAM）。

结果

患者术后切口均一期顺利愈合，未见伤口皮缘坏死。患者麻醉效果均满意，顺利完成手术；术中VAS评分低于3分，仅少量出血，术中可观察到关节屈伸运动恢复，术后TAM评分均为20分。与相应健指相比，患指掌指关节活动度及手指关节TAM无显著变化（

0.05)。

结论

WALANT技术应用于伸直受限型掌指关节交锁手术麻醉效果良好，切口出血少，手术视野清晰，能避免血管、神经损伤，术中可以观察关节活动的恢复，减轻患者疼痛，有利于门诊手术，同时节约社会及医疗资源。

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 metacarpophalangeal 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 （

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

Keywords

references

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