Wide-awake local anaesthesia no tourniquet-assisted subcutaneous anterior ulnar nerve transposition in cubital tunnel syndrome: A retrospective evaluation

Although several studies have demonstrated the successful use of wide-awake local anesthesia no tourniquet (WALANT) technique in cubital tunnel decompression, no prior study has investigated its use in anterior ulnar nerve transposition. This study aimed to retrospectively evaluate the outcomes of patients who underwent ulnar nerve decompression and subcutaneous anterior transposition using WALANT. A total of 41 surgeries were performed on 40 patients between August 2012 and March 2024 by a single surgeon. Patient data including age, sex, surgical side, Dellon satisfaction scale scores, postoperative complications, and satisfaction with anesthesia were collected. All procedures were performed using WALANT. Twelve (30%) patients were female and 28 (70%) were male and the mean postoperative follow-up period was 5.8 weeks (range 4-9 weeks). In the preoperative evaluation according to the Dellon scale, 12 (30%) patients had mild disease, 23 (57.5%) had moderate moderate, 5 (12.5%) had severe disease. Patient satisfaction was evaluated as bad in 3 patients (7.5%), moderate in 11 patients (27.5%) and good in 26 patients (65%). A significant negative correlation was observed between age and satisfaction questionnaire scores (r = -0.27, P = .023). Age also had a significant effect on the likelihood of conversion to general anesthesia (P = .0018). The WALANT anesthesia technique for anterior subcutaneous transposition of the ulnar nerve in cubital tunnel syndrome is safe and effective. The most important point in this regard is patient selection. A prospective cohort study with a larger cohort and longer follow-up time is required to monitor the long-term clinical outcomes.