Wide Awake Open Reduction of Irreducible Metacarpal Phalangeal Joint Dislocations

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Many Canadian surgeons now surgically treat most hand trauma during the day in minor procedure rooms using local anesthetic, instead of in the middle of the night in the main operating room. Surgeons and nurses are more likely to be able to perform better surgery when they are rested during daytime hours than while tired at night. Most patients undergoing wide awake hand surgery for traumatic hand injuries do not require hospital admission as they do not need to wait in line to obtain or recover from sedation. Little to no preoperative workup is required for pure local anesthesia. This is much less expensive and more convenient for patients who have traveled long distances for care.1 We can operate on patients with multiple medical problems safely because we do not use sedation.
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