{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:23:02Z","timestamp":1777951382221,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    This study evaluates the time efficiency and safety of Wide Awake Local Anesthesia No Tourniquet (WALANT) compared to general\/plexus anesthesia in emergency hand surgery.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This single-center, retrospective study analyzed 812 emergency category 2b hand surgeries performed between 2018 and 2024. Patients were divided into 2 groups: local anesthesia (LA), including WALANT, and general\/plexus anesthesia. In collaboration with the Institute for Medical Statistics and Biometry, \u201ctime to intervention\u201d and postoperative surgical complications were prospectively defined as co-primary endpoints. In addition, a descriptive analysis of the study population was conducted, and a matched-pair analysis was performed to account for injury complexity. Statistical analysis included\n                    <jats:italic toggle=\"yes\">t<\/jats:italic>\n                    -tests, Cohen\u2019s d, and Gart and Nam\u2019s method for risk difference.\n                    <jats:bold>Results:<\/jats:bold>\n                    The mean \u201ctime to intervention\u201d was significantly shorter in the LA group (2.2 hours) compared to that in the general\/plexus anesthesia group (4.1 hours). Postoperative surgical complication rates were comparable between the LA (8.5%) and general\/plexus anesthesia (8.2%) groups, with no significant difference observed. WALANT showed a lower complication rate (5.7%) than LA without epinephrine (9.8%). A matched-pair analysis confirmed these findings. Among the general\/plexus anesthesia cases, 16.2% exceeded the recommended 6-hour treatment window, compared to 6.6% in the LA group.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Wide Awake Local Anesthesia No Tourniquet facilitates faster treatment of emergency hand surgery cases while maintaining equivalent quality of care compared to general\/plexus anesthesia. This study highlights the time efficiency and safety of WALANT in emergency settings, supporting its broader application.\n                  <\/jats:p>","DOI":"10.1177\/15589447261437818","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T10:42:13Z","timestamp":1777545733000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["WALANT in Hand Trauma Surgery: Safety and Efficacy"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4174-9079","authenticated-orcid":false,"given":"Ayla A.","family":"Hohenstein","sequence":"first","affiliation":[{"name":"Department of Plastic and Hand Surgery, Medical Center and Faculty of Medicine\u2014University of Freiburg, Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Matros","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Medical Center and Faculty of Medicine\u2014University of Freiburg, Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3838-0543","authenticated-orcid":false,"given":"Cam Tu","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Medical Center and Faculty of Medicine\u2014University of Freiburg, Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1884-8600","authenticated-orcid":false,"given":"Mark","family":"Fricke","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Medical Center and Faculty of Medicine\u2014University of Freiburg, Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4471-3160","authenticated-orcid":false,"given":"Steffen U.","family":"Eisenhardt","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Medical Center and Faculty of Medicine\u2014University of Freiburg, Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nico","family":"Leibig","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery, Medical Center and Faculty of Medicine\u2014University of Freiburg, Freiburg im Breisgau, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.isjp.2020.03.001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-194207000-00057"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1753193417728427"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2005.05.006"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200107000-00017"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000237039.71227.11"},{"key":"e_1_3_2_8_2","unstructured":"Bauer M Auhuber TC Kraus R et al. Glossar perioperativer Prozesszeiten und Kennzahlen Version 2020. Published 2020. Accessed February 3 2024. https:\/\/www.ai-online.info\/images\/AI_Online_First_2020_Bauer_Glossar.pdf"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-023-00499-3"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S3982"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_3_2_12_2","unstructured":"Online-Calculator. Gart and Nam\u2019s continuity-corrected method. Accessed February 11 2025. http:\/\/ssu.sheffield.ac.uk\/diffbinconf\/calc"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.4324\/9780203771587"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008053"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1142\/S2424835519500619"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2020.03.013"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2016.11.019"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002509"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsg.2019.09.011"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.2344\/anpr-68-03-12"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000005969"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2016.10.007"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-024-06104-9"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsg.2022.05.010"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2020.10.011"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/15589447221126764"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/1753193420905205"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002025"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/15589447241284791"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1748659"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447261437818","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15589447261437818","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447261437818","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:48:06Z","timestamp":1777888086000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15589447261437818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":29,"alternative-id":["10.1177\/15589447261437818"],"URL":"https:\/\/doi.org\/10.1177\/15589447261437818","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"article-number":"15589447261437818"}}