Successful Application of Wide-Awake Local Anesthesia No Tourniquet Technique in Internal Fixation of Capitellar Fracture: A Case Report

Abstract

Background: Capitellar fractures are rare elbow injuries. The open reduction and internal fixation (ORIF) method is the treatment of choice in the management of displaced fractures of the capitellum. The surgery is performed under general or high region block anesthesia with the possibility of side effects including bleeding. Meanwhile, the wide-awake local anesthesia with no tourniquet (WALANT) technique has been proposed in some orthopedic surgeries with minimal side effects and without the need for a tourniquet. In this article, we aimed to evaluate the effectiveness of the WALANT anesthesia technique in repairing a humeral capitellum fracture. Methods: This is a report of a patient who suffered a fracture of the capitellum and had it successfully repaired by ORIF and anesthetized with the WALANT technique instead of general anesthesia. Results: It is the first case in which this method of local anesthesia is used. Postoperative evaluation showed anatomic reduction of the fracture. The patient showed normal function of the elbow joint during follow-up. She was very satisfied with the outcome of the surgery and returned to normal activity in the limb within 3 months after the fracture repair. Conclusion: We suggest that the WALANT technique is safe in the fixation of capitellar fractures, providing an effective, reliable, and pain-free anesthesia method without the need for diathermy or tourniquets.