The hematoma block an effective alternative for fracture reduction in distal radius fractures.
9 slide(s) – English – 2011-09-08
Background: An alternative to general anesthesia was tested against hematoma block by a double-blind, randomized clinical trial in reduction of Colles fracture.
Method: 96 patients more than 18 years old with displaced fractures of distal radius were selected from 2007-2009 on the basis of: 1) informed consent; 2) no contraindication to any method of analgesia; 3) no associated injury. Patients were randomized into 2 equal groups. The A group received Propofol intravenously, whereas the B group received 10 ml of 2% Lidocaine Hydrochloride into the fracture hematoma. Fractures are reduced under acceptable criteria. Pain measured by Visual Analogue Scale ( VAS ) was recorded before, during, and after reduction. Time to Emergency department, to manipulation and to hospital discharge is measured. In radiographic before, after reduction and a week later the radial tilt, ulnar migration and dorsal tilt are measured. Loss of these parameters were study statistically data analysis by KW statistics;
Results: 96 patients with displaced fractures of distal radius at mean age 54.3 ( 19-84 ) years old, M / F rate 37 / 59, left / right hand 37 / 58., from 2005-2008 . VAS during reduction was 0 in group A and 0.97 ± 0.7 in group B and VAS after reduction was 2.72 ± 0.7 in group A and 2.25 ± 0.2 in group B. Time to reduction was 2.63 ± 0.96 hr in A and 0.90 ± 0.47 hr in B After a week,21 fractures lose reduction in group A and 22 in group B. Conclusion: Hematoma block by local anesthetic is a safe and effective alternative to intravenous general anesthesia in reduction of Colles fracture.
Key Words : Distal radius fractures, Hematoma block, Intravenous general anesthesia.