Comparison Between Functional Outcomes of Flexor Tendon Repair Under WALANT and Brachial Plexus Block

Not Applicable

Recruiting

• Conditions: Flexor Tendon Rupture
• Interventions: Procedure: FLEXOR TENDON REPAIR

• Registration Number: NCT06149962
• Lead Sponsor: Sohag University

Brief Summary

Although outcomes after flexor tendon repair have reportedly improved with modern treatment, complications are common. Early passive and active motion protocols have improved outcomes of flexor tendon repairs. One potential complication of early motion occurs when the forces produced by this motion exceed the strength of the repair, which leads to gap formation and inhibits healing. Wide Awake Local Anesthesia No Tournique (WALANT) is a new anesthesia technique that has gained popularity among plastic surgeons. It was developed by Dr. Lalonde in Canada, and it involves the use of Lidocaine and adrenaline in the surgical site to control bleeding without the need for a tourniquet. Peripheral nerve blocks are overall safe when performed correctly, there are rare but serious risks associated with them. Risks include block failure, bleeding, infection, damage to surrounding structures, permanent nerve injury, and intravascular uptake of local anesthetic resulting in systemic toxicity.

Detailed Description

WALANT can be applied in both elective and emergency surgeries and is commonly used for procedures involving the hand, wrist, and fingers, such as root tunnels syndromes, trigger finger, and fractures. However, it has some limitations and contraindications, including patients with coagulopathy or on anticoagulant therapy, those with allergies to any of the anesthesia components, or patients with a history of psychiatric disorders or aggressive behavior. Infraclavicular brachial plexus block (ICBPB) is widely used for anesthesia or analgesia during surgery on the hand and forearm. Today, it is most frequently performed using a sagittal ultrasound scan at the lateral infraclavicular fossa (LICF), where the local anesthetic is injected deep to the pectoral muscles. Peripheral nerve blocks are overall safe when performed correctly, there are rare but serious risks associated with them. Risks include block failure, bleeding, infection, damage to surrounding structures, permanent nerve injury, and intravascular uptake of local anesthetic resulting in systemic toxicity.

Study Timeline

• Study Start: 2023-07-10
• Study First Submitted: 2023-08-06
• Status Verified: 2023-11
• Study First Submitted QC: 2023-11-26
• Last Update Submitted: 2023-11-26
• Study First Posted: 2023-11-29
• Last Update Posted: 2023-11-29
• Primary Completion: 2024-07-10
• Study Completion: 2024-07-10

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• Cooperative patients .
• age between 16-60 years.
• Acute flexor tendon injuries of the hand in both genders in medial four fingers.
• Sharp mechanism of injury.
• Single level injury zone 2.

Exclusion Criteria

• Associated fractures close to the tendon injury.

  • Vascular injury requiring revascularization
  • Multiple level injury
  • Combined flexor and extensor laceration
  • Insufficient skin and soft tissue coverage
  • Tendon substance loss
  • Patients with coagulopathy or on anticoagulant therapy
  • Patients with allergies to any of the anesthesia components

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
BRACHIAL BLOCK	FLEXOR TENDON REPAIR	Flexor Tendon Repair under Brachial Plexus Block
WALANT	FLEXOR TENDON REPAIR	Flexor Tendon Repair under Wide-Awake Local Anesthesia No Tourniquet

Primary Outcome Measures

Name	Time	Method
Quick Disabilities of the Arm, Shoulder, and Hand	6 months	Quick Disabilities of the Arm, Shoulder, and Hand using (DASH) scores

Trial Locations

Locations (1)

Sohag university Hospital; 🇪🇬 Sohag, Egypt