Hematoma block for fracture reduction

Hematoma block for fracture reduction

Introduction: Distal radius fractures are one of the commonest fractures and more commonly involve children and elderly. Analgesia during reduction are determined by safety, simplicity, effectiveness and costs. The objective of this study is to evaluate the effectiveness of the Hematoma Block (HB)...

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Autores principales: Suraj Bajracharya, Tamanna Bajracharya, Shriraj Shrestha
Formato: article
Lenguaje:EN
Publicado: Society of Surgeons of Nepal 2018
Materias:
Brachial Plexus Block
Distal forearm fractures
Hematoma Block
Visual Analog Scale
Surgery
RD1-811
Acceso en línea:https://doaj.org/article/1653f09b3b9c4b99a826a7486dd6a720
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spelling oai:doaj.org-article:1653f09b3b9c4b99a826a7486dd6a7202021-12-05T19:15:55ZHematoma block for fracture reduction10.3126/jssn.v21i2.243541815-39842392-4772https://doaj.org/article/1653f09b3b9c4b99a826a7486dd6a7202018-12-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/24354https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction: Distal radius fractures are one of the commonest fractures and more commonly involve children and elderly. Analgesia during reduction are determined by safety, simplicity, effectiveness and costs. The objective of this study is to evaluate the effectiveness of the Hematoma Block (HB) for reduction in distal forearm fractures in a developing country like Nepal. Methods: The study design was double blind randomized control trial performed at tertiary care hospital from July 2016 to August 2017. The patients having radiologically confirmed distal forearm fractures less than 96 hours old in 46 males and 54 females included after obtaining informed consent. 50 patients receiving Brachial Plexus Block (BPB group), and 50 patients receiving HB group during reduction of distal forearm fractures were initially allotted in two arms of randomized group. Pain measured by Visual Analogue Scale (VAS) was recorded before, during, and after reduction. Results: The study showed that HB with (mean ± SD) a VAS score of 2.08 ± 0.85 was as effective as BPB with a VAS of 1.7 ± 0.64 in terms of producing analgesia ( p=0.013), with the advantage of no motor paralysis and a significantly higher reduction rate, odds 3.45, 95% CI 1.52 – 7.85, p = 0.0013. 1/50 patients in brachial plexus block had bronchospasm needing intubation and ICU care where as 1/50 patient with hematoma block and infection which needed incision drainage and external fixation for complete healing. Conclusions: “The Hematoma Block” is to be encouraged in our set up for the reduction of the distal forearm fractures. The technique may be used in those fractures like isolated ulna fractures, minially displaced tibial fractures, fracture fibula where local anesthesia can be easily infiltrated percutaneously The study may be beneficial in managing such fractures and hence, it will help change in therapeutic policies comparing other modalities. Suraj BajracharyaTamanna BajracharyaShriraj ShresthaSociety of Surgeons of NepalarticleBrachial Plexus BlockDistal forearm fracturesHematoma BlockVisual Analog ScaleSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 21, Iss 2 (2018)
institution DOAJ
collection DOAJ
language EN
topic Brachial Plexus Block
Distal forearm fractures
Hematoma Block
Visual Analog Scale
Surgery
RD1-811
spellingShingle Brachial Plexus Block
Distal forearm fractures
Hematoma Block
Visual Analog Scale
Surgery
RD1-811
Suraj Bajracharya
Tamanna Bajracharya
Shriraj Shrestha
Hematoma block for fracture reduction
description Introduction: Distal radius fractures are one of the commonest fractures and more commonly involve children and elderly. Analgesia during reduction are determined by safety, simplicity, effectiveness and costs. The objective of this study is to evaluate the effectiveness of the Hematoma Block (HB) for reduction in distal forearm fractures in a developing country like Nepal. Methods: The study design was double blind randomized control trial performed at tertiary care hospital from July 2016 to August 2017. The patients having radiologically confirmed distal forearm fractures less than 96 hours old in 46 males and 54 females included after obtaining informed consent. 50 patients receiving Brachial Plexus Block (BPB group), and 50 patients receiving HB group during reduction of distal forearm fractures were initially allotted in two arms of randomized group. Pain measured by Visual Analogue Scale (VAS) was recorded before, during, and after reduction. Results: The study showed that HB with (mean ± SD) a VAS score of 2.08 ± 0.85 was as effective as BPB with a VAS of 1.7 ± 0.64 in terms of producing analgesia ( p=0.013), with the advantage of no motor paralysis and a significantly higher reduction rate, odds 3.45, 95% CI 1.52 – 7.85, p = 0.0013. 1/50 patients in brachial plexus block had bronchospasm needing intubation and ICU care where as 1/50 patient with hematoma block and infection which needed incision drainage and external fixation for complete healing. Conclusions: “The Hematoma Block” is to be encouraged in our set up for the reduction of the distal forearm fractures. The technique may be used in those fractures like isolated ulna fractures, minially displaced tibial fractures, fracture fibula where local anesthesia can be easily infiltrated percutaneously The study may be beneficial in managing such fractures and hence, it will help change in therapeutic policies comparing other modalities.
format article
author Suraj Bajracharya
Tamanna Bajracharya
Shriraj Shrestha
author_facet Suraj Bajracharya
Tamanna Bajracharya
Shriraj Shrestha
author_sort Suraj Bajracharya
title Hematoma block for fracture reduction
title_short Hematoma block for fracture reduction
title_full Hematoma block for fracture reduction
title_fullStr Hematoma block for fracture reduction
title_full_unstemmed Hematoma block for fracture reduction
title_sort hematoma block for fracture reduction
publisher Society of Surgeons of Nepal
publishDate 2018
url https://doaj.org/article/1653f09b3b9c4b99a826a7486dd6a720
work_keys_str_mv AT surajbajracharya hematomablockforfracturereduction
AT tamannabajracharya hematomablockforfracturereduction
AT shrirajshrestha hematomablockforfracturereduction
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