Metatarsal osteotomy for hallux valgus under wide-awake local anesthesia with no tourniquet technique

OBJECTIVES: The issue of performing a hallux valgus operation with the wide-awake local anesthesia with no tourniquet (WALANT) technique has not been evaluated before. The objective of this study was to compare the clinical results of patients who underwent the WALANT technique during hallux valgus operation and patients who underwent the procedure with traditional anesthesia (TA). PATIENTS AND METHODS: In this cross-sectional, retrospective study, 34 patients (17 males, 17 females; mean age: 46.1±8.3 years; range, 36 to 62 years) who underwent first metatarsal osteotomy with the diagnosis of hallux valgus disease at the orthopedics and traumatology department of the Private Silivri Anadolu Hospital between November 1, 2018, and June 1, 2020, were divided into two groups according to the surgical approach determined by patient choice: the WALANT group and the TA group. Demographic characteristics, Visual Analog Scale (VAS) scores for pain and anxiety, postoperative satisfaction levels, and complications were recorded. RESULTS: There was no significant difference between the groups in terms of demographic characteristics. The VAS pain score during needle insertion was significantly higher in the WALANT group compared to the TA group (p<0.001). Conversely, the VAS anxiety score was significantly higher in the WALANT group compared to the TA group (p<0.001). The median follow-up time was 5.4 months (interquartile range, 5-6 months). CONCLUSION: This is the first study demonstrating that adequate anesthetic efficacy can be achieved with the WALANT technique for the hallux valgus operation. Acceptable pain scores can be achieved with this technique, and costs are reduced.