The effect of WALANT on outcomes of flexor tenolysis

Özgün Barış Güntürk; Deniz Dikmen Meral; Can Yener; Kubilay Erol; Anıl Koca

doi:10.52312/jdrs.2026.2600

Özgün Barış Güntürk¹, Deniz Dikmen Meral², Can Yener¹, Kubilay Erol¹, Anıl Koca¹

¹Department of Orthopedics and Traumatology, Division of Hand Surgery, EMOT Hospital, İzmir, Türkiye
²Hand Therapy Unit, EMOT Hospital, İzmir, Türkiye

Keywords: Flexor tendon, tenolysis, wide-awake local anesthesia no tourniquet, wide-awake.

Abstract

Objectives: This study aims to evaluate the outcomes of the flexor tenolysis cases with wide-awake local anesthesia no tourniquet (WALANT) and to compare them with cases with other anesthesia types.

Patients and methods: Between March 2004 and March 2024, a total of 104 patients with 150 fingers with flexor tenolysis (71 males, 33 females; mean age: 32.67 ± 11.64 years; range, 16 to 62 years) were included in the study. The WALANT group consisted of 41 patients with 53 fingers, while the conventional anesthesia group consisted of 63 patients with 97 fingers. Pre- and postoperative total active motion (TAM) gains were compared between the two groups and relevant factors were investigated.

Results: Overall TAM gain was 47% in our study cohort. The TAM gain was 55% and 43% in the WALANT group and in the conventional anesthesia group, indicating a statistically significant difference (p = 0.005). The best TAM gains were observed in the clean-cut injury type. The TAM gains were better in the cases without fractures. Age was a significant factor in the tenolysis outcomes, and younger patients had improved outcomes.

Conclusion: Our study results indicate a significant difference in the TAM gain between the WALANT and conventional methods. Taken together, we believe that the application of WALANT in tenolysis of flexor tendon adhesions represents a significant advancement in hand surgery. The ability to perform the procedure under local anesthesia while allowing for immediate assessment of tendon function enhances the surgical precision and results.

Citation: Güntürk ÖB, Meral DD, Yener C, Erol K, Koca A. The effect of WALANT on outcomes of flexor tenolysis. Jt Dis Relat Surg 2026;37(2):510-518. doi: 10.52312/jdrs.2026.2600.