ArticleBone & joint research2020
Fixation of distal radius fractures using wide-awake local anaesthesia with no tourniquet (WALANT) technique: A randomized control trial of a cost-effective and resource-friendly procedure.
Article in Bone & joint research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. It is linked to trial NCT07299383 (Comparison of Local Anesthesia With the Fully Awake Tourniquet-Free Local Anesthesia Technique), which is not on this map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Local Anesthesia With the Fully Awake Tourniquet-Free Local Anesthesia Technique (WALANT) in Central Venous Catheter Insertion Procedure
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Complications and side effects of Wide-Awake Local Anaesthesia No Tourniquet (WALANT) in upper limb surgery: a systematic review and meta-analysis.International orthopaedics · 2024Pooled it
- Fixation of Distal Radius Fractures Under Wide-Awake Local Anesthesia: A Systematic Review.Hand (New York, N.Y.) · 2024Pooled it
- Circumferential periosteal block versus hematoma block for the reduction of distal radius and ulna fractures: a randomized controlled trial.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Trial
- [Application of wide-awake local anesthesia no tourniquet technique in the treatment of acute Achilles tendon rupture].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022Trial
- Article
- Walant in upper limb surgery- a three year experience from a tertiary institute.Journal of hand and microsurgery · 2025Article
- Suture suspension arthroplasty for thumb carpometacarpal osteoarthritis under wide-awake anesthesia.Journal of hand and microsurgery · 2025Article
- Network meta-analysis comparing WALANT, locoregional, local and general anesthesia techniques in carpal tunnel release.EFORT open reviews · 2025Article
- A Prospective Study Comparing Wide-Awake Local Anesthesia No Tourniquet Versus General Anesthesia in Hand Fracture Fixation.Journal of hand surgery global online · 2024Article
- Main Operating Room Versus Field Sterility in Hand Surgery: A Review of the Evidence.Plastic surgery (Oakville, Ont.) · 2024Article
- Cost-reduction Analysis of Percutaneous Pinning of Hand Fractures in an Outpatient Clinic.Plastic and reconstructive surgery. Global open · 2024Article
- Intraosseous Treatment of Bone Marrow Lesions in the Knee: Surgical Technique.Arthroscopy techniques · 2024Article
- A systematic review of tourniquet use in paediatric orthopaedic surgery: can we extrapolate from adult guidelines?EFORT open reviews · 2024Article
- Intraoperative Hemostasis Using WALANT Versus Tourniquet; A Focused Review on Carpal Tunnel Syndrome and Trigger Finger Release.World journal of plastic surgery · 2024Review
- Wide Awake Local Anesthetic No Tourniquet in Hand and Wrist Surgery: Current Concepts, Indications, and Considerations.Plastic and reconstructive surgery. Global open · 2024Article
- Comparison of distal radius fracture plating surgery under wide-awake local anesthesia no tourniquet technique and balanced anesthesia: a retrospective cohort study.Journal of orthopaedic surgery and research · 2023Article
- Below-knee Amputation with Minimally Painful Injection of Tumescent Local Anesthesia.Plastic and reconstructive surgery. Global open · 2023Article
- Proximal Interphalangeal Joint Arthroplasty Using the Wide-Awake Local Anesthesia No Tourniquet Technique.Hand (New York, N.Y.) · 2023Article
- The Efficacy of Wide-Awake Local Anesthesia No Tourniquet (WALANT) in Common Plastic Surgery Operations Performed on the Upper Limbs: A Case-Control Study.Life (Basel, Switzerland) · 2023Article
- Application of WALANT in Diaphyseal Plating of Forearm Fractures: An Observational Study.Journal of hand surgery global online · 2022Article
Corrections and comments
- Retraction · 2023-03-01Concerns/Issues about Data · Investigation by Journal/Publisher · Investigation by Third Party ·
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsWe hypothesized that the wide-awake local anaesthesia with no tourniquet (WALANT) technique is cost-effective, easy to use, safe, and reproducible, with a low learning curve towards mastery, having a high patient satisfaction rate. Furthermore, WALANT would be a suitable alternative for the austere and developing nation environments where lack of funds and resources are a common issue.
methodsThis was a randomized control trial of 169 patients who required surgery for closed isolated distal radius fractures. The study was performed between March 2016 and April 2019 at a public sector level 1 trauma centre. General anaesthesia was used in 56 patients, Bier's block in 58 patients, and WALANT in 55 patients. Data were collected on pre-, peri-, and postoperative parameters, clinical outcome, hospital costs, and patient satisfaction. One-way analysis of variance (ANOVA) was used with a p-value of 0.05 being significant.
resultsOperations with WALANT proceeded sooner, and patients recovered faster, resulting in mean fewer missed working days (7.8 (SD 1.67)) compared with general anaesthesia (20.1 (SD 7.37)) or Bier's block (14.1 (SD 7.65)) (p < 0.001). The WALANT patients did not develop complications, while the other patients did (p < 0.04). Clinical outcomes did not differ, nor did surgeon qualification affect clinical outcomes. Mean hospital costs were lower for WALANT ($428.50 (SD 77.71)) than for general anaesthesia ($630.63 (SD 114.77)) or Bier's block ($734.00 (SD 37.54)) (p < 0.001). Patient satisfaction was also higher (p < 0.001).
conclusionWALANT for distal radius fractures results in a faster recovery, is more cost-effective, has similar clinical outcomes, and has fewer complications than general anaesthesia or Bier's block. This makes WALANT an attractive technique in any setting, but especially in middle- and low-income countries.Cite this article:
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