Wide-awake local anesthesia No tourniquet (WALANT) for reconstruction of flexor pollicis longus ruptures following volar plate fixation of distal radius fractures- A Case series

Background: The flexor pollicis longus tendon rupture following distal radius fractures is a known complication and reconstruction with interposition tendon graft achieved a good outcome. Therefore, this study aims to analyze the outcome of FPL tendon reconstruction using the wide-awake local anesthesia no tourniquet (WALANT) technique. Methods: Seven patients with attritional FPL rupture were retrospectively analyzed between 2014 and 2021. All these patients had FPL reconstruction using palmaris longus interposition graft under WALANT. The patient demographics, Soong volar plate prominence classification, volar plate type, and functional outcome assessment were reviewed. Results: The FPL tendon rupture occurred at a mean of 1.1 years (range, 6 months −3 years) following volar plate fixation. The patients had T-buttress (n ​= ​6) and volar locking plates (n ​= ​1). The mean follow-up of our study was 16.5 months (range 12–19 months). The total interphalangeal joint movement, grip strength, pinch strength, and Kapandji score were significantly less than the uninjured hand (p ​