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Lesson 1

De Quervain's release is a simple enough operation but finding the separate tunnels can be tricky and can take longer than we would have liked. Without a tourniquet, that pressure is off. Using Walant we can relax, get the patient to move to check for subluxation of the tendons and make sure all slips of APL particularly are running smoothly before closure. It's a perfect case to get started, along with a carpal tunnel release, if not even easier.

Key issues using Walant:

  • 10mls of Xylocaine should be plenty
  • Injection subcutaneously then deeper, down to bone, once numb to ensure LA flows into the extensor tunnels
  • Ensure the patient actively moves to check complete release
  • Elevate superficial radial nerve well out of the way of the extensor retinaculum before dividing the latter

Are we missing any?

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