Severe hand contracture treated by external fixation after proximal row carpectomy and awake tenolysis after general anesthesia: A case report

• 作者: Tsumura Takuya Matsumoto Taiichi Matsushita Mutsumi Kishimoto Katsuma Shiode Hayao Murakami Hiroshi
• 来源期刊: 中华创伤杂志英文版
• 关键词: General anesthesia Ilizarov technique Tendons Carpectomy
• 年，卷（期）: 2022,（1）
• 所属期刊栏目: Case Report
• 页码范围: 54-58
• 页数: 5页
• 语种: 中文
• DOI: 10.1016/j.cjtee.2021.08.008

摘要

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 intra-operative 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.