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- Talk
- 21/09/2021
- UK
A Case Study of Patients Treated with Percutaneous Intramedullary Screws, for 5th Metacarpal Fractures, Using the Walant Technique at Hinchingbrooke Hospital
Description
The discussion features a presentation by Dr. Naufal Ahmad on a case series of percutaneous intermediary screw fixation for treating metacarpal fractures under WALANT (Wide Awake Local Anesthesia No Tourniquet). The talk opens with a brief introduction about metacarpal fractures, which comprise less than 10% of upper limb fractures. Dr. Ahmad emphasizes that non-operative management is the most common treatment but indicates that traditional methods using K-wires, plates, and screws can lead to significant scarring and adhesions, adversely affecting functional outcomes.
He introduces findings from recent studies that support the use of retrograde intramedullary fixation employing cannulated headless screws, leading to better clinical results for unstable extra-articular fractures. Dr. Ahmad details the patient selection criteria for this technique, noting that it is particularly suitable for high-demand patients such as athletes, musicians, and students who experience failed conservative treatment.
In the materials and methods section, he describes the retrospective analysis of 15 patients who underwent this procedure, highlighting the use of WALANT with specific anesthesia administration techniques that minimize pain sensation. Throughout the talk, the speaker shares practical operating tips for achieving the best results such as correct entry point placement for screw insertion and managing screw positioning meticulously to avoid damaging surrounding tissues.
The findings suggest that the technique is safe, quick, and effective, with all patients experiencing satisfactory fracture healing within four to six weeks post-operation, as evidenced by DASH scoring. No complications such as infections or loss of reduction were reported during the one-year follow-up. Dr. Ahmad concludes with assessments of the technique's advantages, especially in light of the pandemic, while acknowledging the limitations of the study due to the small sample size and the need for larger, randomized controlled trials to further validate the findings.