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            [0] => Percutaneous scaphoid screwing under WALANT : technical note
        )

    [etablissement] => Array
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            [0] => ORTHOPEDIE, Hôpital Charles Nicolle Tunis
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    [nom] => Array
        (
            [0] => ABAYED
        )

    [prenom] => Array
        (
            [0] => AMAL
        )

    [email] => Array
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            [0] => amal.abayed@gmail.com
        )

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            [0] => 21110987
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            [0] => 
 
Nom prénom: ABAYED A.
Email: amal.abayed@gmail.com
Hôpital: ORTHOPEDIE, Hôpital Charles Nicolle Tunis

 
Nom prénom: BEN ABID A.
Email: benabidahmed9689@gmail.com
Hôpital: ORTHOPEDIE, Hôpital Charles Nicolle Tunis

 
Nom prénom: SANAA M.H.
Email: mohamedhabib.sanaa@yahoo.fr
Hôpital: ORTHOPEDIE, Hôpital Charles Nicolle Tunis

 
Nom prénom: BENAMMOU A.
Email: adnene.benammou@gmail.com
Hôpital: ORTHOPEDIE, Hôpital Charles Nicolle Tunis

 
Nom prénom: KOOLI M.
Email: mondher.kooli@rns.tn
Hôpital: ORTHOPEDIE, Hôpital Charles Nicolle Tunis

 
Nom prénom: BEN SALAH M.
Email: mbensalah94@yahoo.fr
Hôpital: ORTHOPEDIE, Hôpital Charles Nicolle Tunis

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    [mots_cles] => Array
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            [0] => perctuaneous scaphoid screw, wallant,;

        )

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            [0] => 3663
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    [abstract] => Array
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            [0] => https://www.sotcot.tn/wp-content/uploads/gravity_forms/1-734bfe19ec36a1528718899bf7a2927f/2024/03/Percutaneous-scaphoid-screwing-under-WALANT-_-technical-note.docx
        )

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            [0] => amal.abayed@gmail.com
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    [specialite] => Array
        (
            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Introduction
Scaphoid fractures occur in young patients. Conservative treatment requires 3 months to heal. Surgical treatment is an effective technique to reduce the complications related to complications. We are reporting surgical treatment using percutaneous scaphoid screwing fractures under WALANT technique.

Methods
The Wide Awake Local Anesthesia No Tourniquet (WALANT) technique was performed using 10cc Lidocaine (10mg/mL) Adrenaline (0.005 mg/mL) diluted with 9cc saline solution and 1cc Sodium bicarbonate 10mL, all in 20 cc syringe. A 27 gauge needle was used for cutaneous injection. Median, ulnar and radial blocks of the wrist were performed, 5 mL each. Xylocaine 2% was used for intra articular injection diluted with 9cc saline solution. 

Results
We report two cases of percutaneous scaphoid screwing under Walant. The first patient is a right-handed 17 year-old patient. The second patient is a right-handed 22 year-old daily worker. Both patients presented with a wrist trauma occurring after a road traffic accident. Clinical examination found a pain of the tubercle of the scaphoid and at the traction of the thumb. Pinch test was positive in both cases. The patients had a cast for three to seven days initially. No cutaneous or neurovascular injuries were found. Xray of both patients showed a non displaced scaphoid waist fracture. Patients were operated on using a volar incision. Initial Xrays were performed before starting the surgery in order to confirm the non displacement of the fracture. We used a retrograde screwing.The insertion point of the K-wire was located using Fluoroscopie. Cannulated headless (Herbert) screw of 2.5 mm were inserted. The mean operative time was 40 minutes. The active mobility of the thumb was obtained peroperatively. We prescribed a 6-week immobilization using a removal wrist splint for both patients.

Conclusion
Percutaneous scaphoid screwing under Walant technique offers a better functional result : short immobilization and preserves the palmar ligament complex and local vascularity. It is a safe and cost-effective technique. The procedure must be explained to the patient to obtain his/her cooperation. It is used for non/minimally displaced fractures of scaphoid waist of less than 2 mm.
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