Hematoma Block for Distal Radius Fracture

Beth Israel Lahey Health

Status: Enrolling

Conditions: Distal Radius Fracture

Treatments: Other: ultrasound guide

Study type: Interventional

Funder types: Other

Identifiers

NCT02346929

2014P000173

Details and patient eligibility

About

The purpose of this study is to determine the efficacy of ultrasound guided hematoma block versus traditional "blind" hematoma block for analgesia in distal radius fracture reduction.

Full description

Hematoma blocks are safe and effective in providing analgesia for fracture reduction1-4. They involve injecting lidocaine directly into the fracture line for analgesia. The physician aspirates blood prior to injection to confirm placement in the hematoma created by the fracture. However, the procedure can be technically difficult if the fracture line is difficult to palpate, for example, due to significant swelling or body habitus. Ultrasound has been shown to improve efficacy in other analgesic procedures such as peripheral nerve blocks5 and also in identifying fracture lines6. There have been case reports and case series which have shown the feasibility and effectiveness of ultrasound guided hematoma blocks for analgesia in patients undergoing reduction for distal radius fractures7,8. To our knowledge there are no randomized controlled trials comparing the use of ultrasound guided hematoma blocks versus traditional hematoma blocks in achieving analgesia for distal radius fracture reduction.

In this study, we will determine if ultrasound improves the efficacy of analgesia when performing hematoma blocks for reduction of distal radius fractures.

Enrollment: 115 estimated patients

Sex: All

Ages: 18 to 100 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adult patient ≥ 18 years old presenting to the emergency department with complaint of distal radius fracture

Exclusion criteria

• High acuity/distress per the Attending ED physician
• Altered mental status or intoxication
• Aphasia, mental retardation, dementia, or insurmountable communication barrier
• Acute psychiatric illness

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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115 participants in 2 patient groups

ultrasound-guided hematoma block

Experimental group

Description:

Patients in this arm will receive a bed-side ultrasound guided hematoma block with analgesia (0.25% bupivacaine)

Treatment:

Other: ultrasound guide

traditional hematoma block

No Intervention group

Description:

Patients in this arm will have the hematoma block of the distal radius fracture with no ultrasound for guidance with analgesia (0.25% bupivacaine)