KNOW THE BENEFITS OF WIDE-AWAKE HAND & WRIST SURGERY.

What Is Wide-Awake Hand & Wrist Surgery? Wide-awake hand & wrist surgery is pain-free surgery performed without general anesthesia or sedation. Also known as WALANT (wide-awake, local anesthesia, no tourniquet), this innovative surgical technique allows patients to stay fully awake during their procedure.

Instead of using systemic anesthesia, which knocks you out and leaves you feeling groggy afterward, wide-awake hand surgery uses local anesthesia similar to what your dentist uses.

Many patients appreciate this option because it requires minimal preparation and allows for a faster recovery and return to everyday activities.

Common Hand and Wrist Conditions

Your hands and wrists are complex structures that are vulnerable to acute injuries, chronic conditions, and aging.

Conditions affecting the hands and wrists may strike at any age. However, they tend to happen more often in people who work with their hands or who engage in repetitive processes on a daily basis, such as computer users or those performing assembly-line work.

Among the conditions most frequently treated with wide-awake hand surgery is carpal tunnel syndrome, which occurs when swelling in the passageway at the base of the hand (known as the carpal tunnel) compresses and pinches the median nerve. Left untreated, carpal tunnel syndrome can lead to permanent nerve damage.

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Advantages of Staying Awake During Surgery At first you may think it’s odd to stay awake during surgery. But the truth is, most patients love the advantages of wide-awake hand surgery, including:

• Minimal pre-surgery preparations: Wide-awake hand surgery provides convenience because there is no need for prep work that is required if you were to undergo anesthesia.

• Convenience: Because wide-awake hand surgery uses two local anesthetics (lidocaine with epinephrine) rather than sedation or general anesthesia, patients recover quickly after surgery. You can eat the morning of your surgery, drive yourself to and from the hospital, and resume normal activities sooner than with general anesthesia.

• No intravenous line: The surgical team delivers your local anesthesia through tiny injections in your hand and wrist rather than an IV, which can bruise and cause discomfort.

• No tourniquet: Some types of traditional hand surgery use an uncomfortable tourniquet to help limit bleeding. There’s no need for a tourniquet in wide-awake hand surgery because the epinephrine in the local anesthesia controls bleeding.

• Interaction for better outcomes: Surgery for certain conditions, such as fixing fractures or tendons, is more successful when your surgeon can “test” the repair during the procedure by asking you to perform actions like bending your fingers. That’s not possible when you’re asleep.

• Fewer side effects: Wide-awake hand surgery avoids the side effects that can come with general anesthesia and sedation, such as nausea, vomiting, and fatigue.

• More pleasant recovery: Wide-awake hand surgery typically causes less bruising and swelling and requires smaller amounts of postoperative narcotic pain medication than traditional surgery.

• Access: Using local rather than general anesthesia makes hand surgery possible even for people

for whom anesthesia is not recommended because of certain medical conditions.

Symptoms to Watch For

The following symptoms are associated with common hand or wrist conditions:

• Pain anywhere in your fingers, hands, or wrists either at rest or in motion• Numbness in any of your fingers• Tingling in your hands or wrists• Clicking of your fingers• A “stuck” feeling in your fingers, especially in a trigger-pulling position• Trouble sleeping because of hand or wrist symptoms • Weak grip or a tendency to drop things

Hand and wrist conditions have various treatments. When conservative measures don’t provide

the relief you need, your doctor may recommend surgery.

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Why UConn Health Hand & Wrist?

The UConn Health Hand & Wrist team includes three surgeons who are fellowship-trained in hand

and wrist orthopedic surgery. We’ve performed more wide-awake hand and wrist surgeries than

any other providers in Connecticut. Our team also features experienced orthopedic advanced

practice registered nurses and occupational therapists who are specially trained in hand therapy.

Whether you need an operation or nonsurgical treatments, our team can help.

Meet with One of Our Surgeons

If you’re experiencing pain, numbness, or other symptoms in your hands or wrists, you won’t

have to wait long for our team to see you. Appointments with one of our surgeons can be made

within 72 hours.

Get fast relief for your hand or wrist pain. To schedule a visit today, call the Hand & Wrist Team

at 860.679.4253.

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3 Times More Likely

Risk FactorsAn overactive pituitary gland, an underactive thyroid gland, and rheumatoid arthritis are all risk factors for developing carpal tunnel syndrome.

Some conditions that can be treated using wide-awake hand surgery include:

• Arthritic conditions• Carpal tunnel syndrome• De Quervain’s tenosynovitis• Dupuytren’s contracture• Fracture fixation• Injuries to the hands or wrists• Ligament repairs• Mass removal• Nerve compression

Trigger FingerAlso known as stenosing tenosynovitis, this is a condition that causes stiffness, pain, and a sensation of catching or locking when you bend and straighten one or more of your fingers.

Nonsurgical hand and wrist treatments include:

• Ice or heat• Ultrasound• Electrical stimulation• Occupational and physical therapy• Stretching• Exercise• Rest• Splinting• Corticosteroid injections

The human hand contains 27 bones,ii

and the wrist contains 8 bones.iii

2/3RDs

Nearly two out of three patients who had surgery for carpal tunnel syndrome prefer wide-awake hand surgery with local anesthesia over surgery with general anesthesia.iv

Women are three times more likely than men to develop carpal tunnel syndrome.i

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“Wide-Awake Surgery (video).” American Society for Surgery of the Hand. http://www.assh.

org/handcare/Anatomy/Video-Player-Page/lvid/55052/mvid/14961/Wide-Awake-Surgery

“Carpal Tunnel Syndrome.” MedlinePlus. https://medlineplus.gov/carpaltunnelsyndrome.html

“Carpal Tunnel.” UConn Health Orthopedics & Sports Medicine. https://health.uconn.edu/

orthopedics-sports-medicine/2018/02/05/carpal-tunnel-my-hand-is-numb-tingly-and-i-cant-

sleep/

“Carpal Tunnel Syndrome Information Page.” National Institute of Neurological Disorders and

Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Carpal-Tunnel-Syndrome-Informa-

tion-Page

“Carpal Tunnel Syndrome Fact Sheet.” National Institute of Neurological Disorders and

Stroke. https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/carpal-

tunnel-syndrome-fact-sheet

“Study Results Indicate Most CTR Patients Preferred to Be Wide Awake During Surgery.”

American Academy of Orthopaedic Surgeons. https://www.aaos.org/News/DailyEdi-

tion2018/Wednesday/007/

i “Carpal Tunnel Syndrome Information Page.” National Institute of Neurological Disorders

and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Carpal-Tunnel-Syndrome-In-

formation-Page ii “How Do Hands Work?” InformedHealth.Org via NCBI. https://www.ncbi.nlm.nih.gov/books/

NBK279362/ iii “Hand and Wrist.” Innerbody. https://www.innerbody.com/image/skel13.html iv “Study Results Indicate Most CTR Patients Preferred to Be Wide Awake During Surgery.”

American Academy of Orthopaedic Surgeons. https://www.aaos.org/News/DailyEdi-

tion2018/Wednesday/007/

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