RESUMO
Human hands have a complex anatomical structure. The thumb, being an integral part of the hand, has an essential function in gripping. In this sense, thumb fractures account for 4% of all hand fractures (it may occur in association with fractures of the trapezium). The majority of hand fractures should be treated non-surgically and surgeons must avoid unnecessary surgery. Historically, hand surgery has used a combination of local/regional/general anaesthesia and a tourniquet. This study aims to carry out a systematic review to determine whether the WALANT technique is an advantageous alternative to conventional anaesthesia for surgical procedures on thumb injuries, in terms of patient function and pain. METHOD: We conducted a search in the following databases: Pubmed/Medline, EBSCOhost, Web of Science, Scopus, ScienceDirect and Google Scholar, using the equation "WALANT" OR "Wide Awake Local Anesthesia No Tourniquet" AND "thumb pathology". RESULTS: In five of the 584 articles included, two studied trapeziometacarpal osteoarthritis, one De Quervain's disease and the remaining two flexor injuries. WALANT showed good results in active movements, but with similar levels of pain between anaesthetics. Patients were more anxious during general anaesthesia, plus the fact that they were fasting and suspending medication. CONCLUSION: WALANT is a convenient and favourable option in several studies. It has been demonstrated the benefits in terms of return to function and pain.
RESUMO
The purposes of the study were to identify whether differences exist between Spanish children with ASD and neurotypical development in relation to Activities of Daily Living (ADL), playfulness, and sensory processing; as well as to confirm whether a relation exists between those areas and sensory processing. STUDY DESIGN: A descriptive cross-sectional study. METHODS: Forty children, 20 with a diagnosis of ASD and 20 with neurotypical development, were recruited. The measurement tools used were the Pediatric Evaluation of Disability Inventory (PEDI), Test of Playfulness (ToP), and Sensory Processing Measure (SPM). RESULTS: The sensory processing of children with ASD were related to decreased functional skills performance of ADL (F = 94.4, p = 0.00) and playfulness (p = 0.00) than neurotypical children; in addition, the problems of sensory reactivity were associated with worse development in these occupational areas (p = 0.00 for both Spearman correlations). CONCLUSIONS: Children with ASD present worse performance of functional skills and playfulness than neurotypical ones. Likewise, sensory reactivity is related to the development in the occupational areas.
