Hematoma block local anesthesia for closed reduction of Colles-type fractures

ABSTRACT

To describe the outcome of hematoma block local anesthesia for closed reduction of Colles-type fractures in emergency care setting. This descriptive study was conducted at Khalifa Gul Nawaz Teaching Hospital and District Headquarters Teaching Hospital Bannu, from February 2009 to August 2010. A total of 70 patients having Colles-type fractures were recruited for this study. Closed reduction and plaster casting was performed under HB in Accident and Emergency Department. Pre-and post-reduction radiographic assessment was done. A questionnaire about pain perception was administered to patients. It included a visual analogue scale as well. Fractures requiring re-manipulation were noted. Any local or systemic complications of anesthesia were recorded. Patients were sent home 3 hours after reduction. Follow-up of the patients was done up to 12 weeks. Out of 70 patients, 30 were males and 40 were females. They were in the age range of 20-80years. On assessing their pain perception with VAS, during closed reduction under HB, 36 patients had no pain, 24 had mild pain, 6 were feeling moderate pain, and 4 were feeling severe pain. 12 patients required remanipulation for improper reduction. 2 patients developed carpal tunnel syndrome, 3 developed reflex sympathetic dystrophy and one developed localized infection at the site of infiltration. No systemic complications of anesthesia were noted. HB can be used effectively for closed reduction of Colles-type fractures, especially in a district hospital which lacks advanced anesthesia and intensive care facilities