ArticleOrthopedic reviews2026
Wide-Awake Local Anesthesia No Tourniquet: From Elective Hand Surgery to Fracture Fixation. A Systematic Review, Meta-Analysis, and Narrative Synthesis.
Article in Orthopedic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: WALANT is well established in elective hand surgery, where it has demonstrated favorable clinical outcomes and improved perioperative efficiency. More recently, its use has expanded to selected upper-extremity fracture procedures, but whether the benefits are maintained remains uncertain. This systematic review combined meta-analysis and narrative synthesis to evaluate the clinical outcomes, safety, patient-reported outcomes, and perioperative efficiency of WALANT across elective hand surgery and fracture fixation. Objective: To evaluate the contemporary evidence for WALANT across elective and acute upper-extremity surgery and determine whether the established benefits of elective surgery are preserved in selected fracture procedures. Methods: A systematic review and meta-analysis was conducted according to PRISMA 2020. PubMed, Embase, and the Cochrane Library were searched for comparative studies published between January 2018 and November 2025. Risk of bias was assessed using RoB2 and ROBINS-I. Random-effects meta-analysis and structured narrative synthesis were performed. Results: Sixteen studies met the inclusion criteria. Meta-analysis showed no significant differences in complications (RR 0.37, 95% CI 0.12-1.16) or revision procedures (RR 0.88, 95% CI 0.19-4.15). Functional outcomes were comparable across elective and acute procedures. WALANT consistently improved perioperative efficiency (MD -11.2 minutes, 95% CI -15.4 to -6.9), and subgroup analyses demonstrated that the favorable findings established in elective surgery were largely maintained in selected fracture fixation procedures. Conclusions: The favorable outcomes established for WALANT in elective hand surgery appear to be maintained in selected acute upper-extremity fracture procedures, supporting its role as a safe and resource-efficient option across selected upper-extremity surgery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.