Wide-Awake Hemi-hamate Arthroplasty for Chronic PIPJ Fracture-Dislocation: A Case Report

Abstract

Wide-awake local anaesthesia, no tourniquet (WALANT) has been reported for upper extremity procedures of varying complexities ranging from simple tendon repairs to more complicated soft tissue and bony reconstructions. Hemihamate arthroplasty under WALANT has yet to be described in English literature. We report a case of a chronic dorsal PIPJ fracture-dislocation who underwent open reduction followed by Hemi-hamate Arthroplasty under wide-awake anaesthesia. There was adequate visualization during the surgery with no additional anaesthesia required. Active intraoperative range of motion and joint stability testing was possible with no pain experienced throughout the procedure. 10-month post-operative follow-up showed excellent range of motion with occasional tolerable pain during maximal finger flexion and power grip. Wide-awake anaesthesia is a viable and safe alternative for hemi-hamate arthroplasty.

Keywords

• walant
• pipj fracture-dislocation
• hemi-hamate arthroplasty