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J Wrist Surg
DOI: 10.1055/s-0044-1788776
Scientific Article

The Hematoma Block versus Hematoma Plus Wrist Nerve Block in the Reduction of Distal Radius Fractures

Isidro Jiménez 
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
,
Manuel Aniel-Quiroga Bilbao
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
,
Alejandro Monge-Baeza
2   Servicio de Cirugía Ortopédica y Traumatología, Hospital San Juan de Dios del Aljarafe, Sevilla, Spain
,
Giovanni Fruner
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
,
Alba García-Toledo
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
,
Alejandro Liñán-Padilla
2   Servicio de Cirugía Ortopédica y Traumatología, Hospital San Juan de Dios del Aljarafe, Sevilla, Spain
› Author Affiliations Funding This work was supported by the Colegio Oficial de Médicos de Las Palmas Foundation (Grant number: XXVIII Edición Becas I + E—2023).
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Abstract

Background Distal radius fractures are extremely common. Most of them can be treated conservatively, but there are still many controversies about this nonoperative treatment. The purpose of this study was to assess whether the pain experienced during distal radius fracture reduction using the hematoma block plus a nerve block at the wrist is less than the perceived pain using an isolated hematoma block and whether the success of the closed reduction remains at least the same.

Methods A total of 192 patients were included in a comparative study to assess whether the pain experienced during wrist fracture reduction using the hematoma block plus a nerve block at the wrist was less than using an isolated hematoma block and whether they were equally effective.

Results The mean Visual Analog Scale (VAS) for pain at the wrist was 4.6 in the hematoma plus nerve block and 5.1 in the isolated hematoma block. The score at the fingers was 5.2 in the hematoma plus nerve block and 7.3 in the hematoma block. The success of the procedure was the same among groups.

Conclusions The hematoma plus nerve block is more effective than the isolated hematoma block in reducing the pain during wrist fracture reduction, especially for fingers pain. The mean VAS was far from ideal and further focused research can be very useful because of the great clinical impact it can have.

Level of Evidence Therapeutic study. Prospective cohort study—Level II.

Keywords

block - distal radius - hematoma - pain - reduction - wrist

Ethical Approval

Ethical approval for this study was obtained from Complejo Hospitalario Universitario Insular—Materno Infantil human research committee (CEI/CEIm 2022-116-1)


Statement of Informed Consent

Written informed consent was obtained from all subjects before the study.


Statement of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.


Authors' Contribution

I.J., M.A.Q., and A.L.P. researched literature, conceived the study, and wrote the first draft of the manuscript. I.J. and A.L.P. were involved in protocol development and gaining ethical approval. M.A.Q., A.M.B., G.F., and A.G.T. were involved in patient recruitment. I.J. and A.L.P. were involved in data analysis. All authors reviewed and edited the manuscript and approved the final version of the manuscript.




Publication History

Received: 04 April 2024

Accepted: 09 July 2024

Article published online:
05 August 2024

© 2024. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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