Wide-awake local anaesthesia, no tourniquet (WALANT) has been reported for upper extremity procedures of varying complexities ranging from simple tendon repairs to more complicated soft tissue and bony reconstructions. Hemi-hamate arthroplasty under WALANT has yet to be described in English literature. We report a case of a chronic dorsal PIPJ fracture-dislocation who underwent open reduction followed by Hemi-hamate Arthroplasty under wide-awake anaesthesia. There was adequate visualization during the surgery with no additional anaesthesia required. Active intra-operative range of motion and joint stability testing was possible with no pain experienced throughout the procedure. 10-month post-operative follow-up showed excellent rangeof motion with occasional tolerable pain during maximalfinger flexion and power grip. Wide-awake anaesthesia is aviable and safe alternative for hemi-hamate arthroplasty.
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