Periosteal nerve block versus haematoma block for closed reduction of distal radius fractures in Korle Bu Teaching Hospital

Abstract

Background: Distal radius fractures are common injuries seen by orthopaedic surgeons. Majority are managed non-operatively by manipulation and casting.

Objective: We sought to compare two local anaesthetic techniques; periosteal nerve block and haematoma block in terms of anaesthetic effect and adequacy of fracture reduction in the closed reduction and manipulation of distal radius fractures.

Methods: 84 patients with distal radius fractures presenting to the Trauma and Orthopaedic unit of the Korle Bu Teaching Hospital who met the inclusion criteria were recruited for a randomized clinical trial. Group A received periosteal nerve block while group B received haematoma block. The two groups were compared for anaesthetic effect using the numeric pain rating scale as well as adequacy of fracture reduction using  Sarmiento’s modification of Lidstrom’s criteria. Data analysis was done with Statistical Package for Social Sciences (SPSS 20).

Results: 61.9% of the patients were aged below 60 years with a mean age of 54.85+15.816 years. The drop in mean pain scores in each group from before local anaesthetic administration to fifteen minutes after infiltration and through fracture manipulation was statistically significant. However, between the two groups there is no significant difference. Majority of the patients had excellent or good fracture reduction with very few having fair reduction in both groups. None had poor reduction.

Conclusion: Both periosteal nerve block and haematoma block are effective local anaesthetic techniques for closed manipulation and reduction of distal radius fractures.