Severe hand contracture treated by external fixation after proximal row carpectomy and awake tenolysis after general anesthesia: A case report.
10.1016/j.cjtee.2021.08.008
- Author:
Takuya TSUMURA
1
;
Taiichi MATSUMOTO
2
;
Mutsumi MATSUSHITA
2
;
Katsuma KISHIMOTO
2
;
Hayao SHIODE
2
;
Hiroshi MURAKAMI
2
Author Information
1. Department of Orthopedic Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-0052, Japan. Electronic address: tt13969@kchnet.or.jp.
2. Department of Orthopedic Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-0052, Japan.
- Publication Type:Case Reports
- Keywords:
Carpectomy;
General anesthesia;
Ilizarov technique;
Tendons
- MeSH:
Adult;
Anesthesia, General;
Anesthesia, Local;
Brain Neoplasms;
Contracture/surgery*;
Dissection;
External Fixators;
Fracture Fixation;
Humans;
Male;
Wakefulness
- From:
Chinese Journal of Traumatology
2022;25(1):54-58
- CountryChina
- Language:English
-
Abstract:
Wide-awake local anesthesia has many advantages. We describe a new method to use wide-awake local anesthesia with more flexibility. A 32-year-old man with a severe right-hand contracture after an iatrogenic tourniquet accident during an anterolateral thigh flap for a partial hand amputation underwent contracture release using external fixation after proximal row carpectomy and subsequent tenolysis. We performed most of the tenolysis procedure under general anesthesia and the final stage with an intraoperative assessment of active finger movement and dissection under local anesthesia. He regained his grip strength 2.5 years post-injury. General anesthesia is useful to treat a surgical site with extensive hard scars, whereas local anesthesia is useful for adjusting tension in an awake patient. The indication for wide-awake surgery is yet to be established; our method of combining general and local anesthesia in the tenolysis procedure illustrates the possibilities in expanding this method.
