Comparison between Functional Outcomes of Flexor Tendon Repair Under Wide-Awake Local Anaesthesia No Tourniquet and Brachial Plexus Block

Background: Flexor tendon injuries have long been a significantchallenge in hand surgery, with an incidence of approximately4.83 per 100,000 people. However, debates persistregarding the optimal repair techniques and rehabilitationapproaches.Objective: This study aims to gather additional data on thefunctional outcomes of flexor tendon repair performed underWide-Awake Local Anesthesia No Tourniquet (WALANT)compared to Brachial Plexus Block (BPB).Patients and Methods: All patients who underwent a primaryflexor tendon repair had a tendon injury in zone I or II.A total of 30 flexor tendon repairs were done which meet theinclusion criteria. Simple randomization was used that oddnumbered patients were operated with WALANT and evennumbered patients with BPB.Results: A total of thirty flexor tendon repairs in zone I orII were included in the final evaluation. This group comprised20 males and 10 females, with an average age of 28 years (SD:8) and a mean follow-up of 6 months. Age was insignificantlydifferent between the two groups. There was significantlyhigher mean operative time in group II (BPB) compared togroup I (WALANT) (p = <.001). The Pain of Procedure by themean VAS score was insignificantly different between the twostudied groups (p = 0.5) There were insignificant differencesbetween the two studied groups as regard the mean DASHscore (p = 0.1).Conclusions: The Wide-Awake Local Anesthesia NoTourniquet (WALANT) technique is an effective approach forflexor tendon repair in Zone II, yielding comparable functionaloutcomes and complication rates to Brachial Plexus Block(BPB). Additionally, WALANT offers significant benefits,including shorter operative time, fewer anesthesia-related delays,and reduced postoperative pain, leading to decreased analgesicuse.