Tóm tắt
Background: Wide-awake local anesthesia no tourniquet (WALANT) enables pain control, a suitable surgical field, and active intraoperative motion assessment during hand surgery. This study evaluated early clinical outcomes, perioperative experience, and patient satisfaction after open trigger finger release under WALANT.
Materials and Methods: This prospective descriptive case series included 54 patients with 67 affected fingers who underwent open A1 pulley release under WALANT at Hue University of Medicine and Pharmacy Hospital between May 2025 and June 2026. Outcomes included anesthetic adequacy, surgical field quality, active finger motion, early complications, pain, anxiety, patient experience, and satisfaction.
Results: All 67 finger procedures were completed with adequate anesthesia without supplemental local anesthetic or unplanned tourniquet use; 62/67 (92.5%) had a good surgical field. After release, all fingers achieved full active flexion-extension without residual triggering or locking, and no early complications were identified at the 7-day follow-up. Anxiety decreased significantly across perioperative assessments (p < 0.001), while postoperative pain remained low and changed significantly over time (p = 0.033). The mean satisfaction score was 4.78 ± 0.42/5; all patients were satisfied or very satisfied, 98.1% preferred WALANT for a similar future procedure, and 72.2% were discharged on the day of surgery.
Conclusion: Open trigger finger release under WALANT was associated with immediate resolution of triggering, no recorded complications through postoperative day 7, and high patient satisfaction. These findings describe early clinical outcomes and patient acceptance within the observed care pathway; they do not establish longer-term functional recovery or the independent effect of WALANT.
| Đã xuất bản | 15-11-2026 | |
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| Số tạp chí | Tập 16 Số S-3 (2026) | |
| Phân mục | Nghiên cứu | |
| DOI | 10.34071/jmp.2026.S-3.23 | |
| Từ khóa | trigger finger, WALANT, A1 pulley release, early clinical outcomes, patient satisfaction |
công trình này được cấp phép theo Creative Commons Attribution-phi thương mại-NoDerivatives 4.0 License International .
Bản quyền (c) 2026 Hue Journal of Medicine and Pharmacy
Makkouk AH, Oetgen ME, Swigart CR, Dodds SD. Trigger finger: etiology, evaluation, and treatment. Curr Rev Musculoskelet Med. 2008;1(2):92-96.
Fiorini HJ, Tamaoki MJ, Lenza M, Gomes Dos Santos JB, Faloppa F, Belloti JC. Surgery for trigger finger. Cochrane Database Syst Rev. 2018;2:CD009860.
Hansen RL, Søndergaard M, Lange J. Open surgery versus ultrasound-guided corticosteroid injection for trigger finger: a randomized controlled trial with 1-year follow-up. J Hand Surg Am. 2017;42(5):359-366.
Blazar PE, Zhang D, Bryant JK, Benavent KA, Yeung CM, Earp BE. Patient-perceived outcomes of recovery after trigger digit release. J Hand Surg Am. 2024;49(12):1264.e1-1264.e6.
Lalonde D, Bell M, Benoit P, Sparkes G, Denkler K, Chang P. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie Project clinical phase. J Hand Surg Am. 2005;30(5):1061-1067.
Lalonde DH, Wong A. Dosage of local anesthesia in wide awake hand surgery. J Hand Surg Am. 2013;38(10):2025-2028.
Mohd Rashid MZ, Sapuan J, Abdullah S. A randomized controlled trial of trigger finger release under digital anesthesia with (WALANT) and without adrenaline. J Orthop Surg (Hong Kong). 2019;27(1):2309499019833002.
Lee SK, Kim WS, Choy WS. A randomized controlled trial of three different local anesthetic methods for minor hand surgery. J Orthop Surg (Hong Kong). 2022;30(1):23094990211047280.
Teo I, Lam W, Muthayya P, Steele K, Alexander S, Miller G. Patients’ perspective of wide-awake hand surgery—100 consecutive cases. J Hand Surg Eur Vol. 2013;38(9):992-999.
Pina M, Cusano A, LeVasseur MR, Olivieri-Ortiz R, Ferreira J, Parrino A. Wide awake local anesthesia no tourniquet technique in hand surgery: the patient experience. Hand (N Y). 2023;18(4):655-661.
Naude JJ, Koch O, Schmidt LW, Le Roux TLB. Positive patient experience of wide awake local anaesthesia no tourniquet (WALANT) hand surgery in the government setting: a prospective descriptive study. SA Orthop J. 2021;20(3):141-146.
Levit T, Lavoie DCT, Dunn E, Gallo L, Thoma A. Trigger finger release using wide-awake local anesthesia no tourniquet versus local anesthesia with a tourniquet: a systematic review and meta-analysis. Hand (N Y). 2025;20(4):533-541.
Wolfe SW, Pederson WC, Kozin SH, Cohen MS, editors. Green’s operative hand surgery. 8th ed. Philadelphia: Elsevier; 2022.
de Buys M, Tsama M, Aden AA. Patient satisfaction following wide awake local anaesthetic no tourniquet hand surgery. SA Orthop J. 2022;21(1):39-43.
Stirling PHC, Jenkins PJ, Duckworth AD, Clement ND, McEachan JE. Functional outcomes of trigger finger release in non-diabetic and diabetic patients. J Hand Surg Eur Vol. 2020;45(10):1078-1082.
Lim MH, Lim KK, Rasheed MZ, Narayanan S, Tan ABH. Outcome of open trigger digit release. J Hand Surg Eur Vol. 2007;32(4):457-459.
Bruijnzeel H, Neuhaus V, Fostvedt S, Jupiter JB, Mudgal CS, Ring DC. Adverse events of open A1 pulley release for idiopathic trigger finger. J Hand Surg Am. 2012;37(8):1650-1656.
Maliha SG, Cohen O, Jacoby A, Sharma S. A cost and efficiency analysis of the WALANT technique for the management of trigger finger in a procedure room of a major city hospital. Plast Reconstr Surg Glob Open. 2019;7(11):e2509.
Far-Riera AM, Pérez-Uribarri C, Sánchez Jiménez M, Esteras Serrano MJ, Rapariz González JM, Ruiz Hernández IM. Prospective study on the application of a WALANT circuit for surgery of tunnel carpal syndrome and trigger finger. Rev Esp Cir Ortop Traumatol (Engl Ed). 2019;63(6):400-407.
Beaton DE, Wright JG, Katz JN; Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am. 2005;87(5):1038-1046.