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Randomized Controlled Trial
. 2023 Feb;49(1):107-113.
doi: 10.1007/s00068-022-02078-8. Epub 2022 Aug 18.

Circumferential periosteal block versus hematoma block for the reduction of distal radius and ulna fractures: a randomized controlled trial

Ali Lari  1 , Ali Jarragh  2 , Mohammad Alherz  3 , Abdullah Nouri  4 , Mousa Behbehani  4 , Naser Alnusif  4
Affiliations
Randomized Controlled Trial

Circumferential periosteal block versus hematoma block for the reduction of distal radius and ulna fractures: a randomized controlled trial

Ali Lari et al. Eur J Trauma Emerg Surg. 2023 Feb.

Abstract

Purpose: To assess the analgesic efficacy of the circumferential periosteal block (CPB) and compare it with the conventional fracture hematoma block (HB).

Methods: This study was a prospective single-center randomized controlled trial performed in a national orthopedic hospital. Fifty patients with displaced distal radius (with or without concomitant ulna) fractures requiring reduction were randomized to receive either CPB or HB prior to the reduction. Pain was sequentially measured using the visual analogue scale (VAS) across three stages; before administration of local anesthesia (baseline), during administration (injection) and during manipulation and immobilization (manipulation). Further, the effect of demographic factors on the severity of pain was analyzed in multivariate regression. Finally, complications and end outcomes were compared across both techniques.

Results: Patients receiving CPB experienced significantly less pain scores during manipulation (VAS = 0.64) compared with HB (VAS = 2.44) (p = < 0.0001). There were no significant differences between groups at baseline (P = 0.55) and injection (P = 0.40) stages.

Conclusion: The CPB provides a superior analgesic effect over the conventional HB with no documented complications in either technique.

Level of evidence: Therapeutic Level II.

Keywords: Analgesia; Distal radius fracture; Hematoma block; Nonoperative management; Periosteal block; Reduction.

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Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
CONSORT Flowchart displaying enrolment, allocation, follow up and analysis of participants
Fig. 2
Fig. 2
Bonferroni’s multiple comparison test for differences in pain scores between the block methods
See this image and copyright information in PMC

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