The Efficacy Of The Hematoma Block For Fracture Reduction In The Distal Forearm Fractures: A Double Blind Randomized Controlled Trial

Abstract

Objectives: To evaluate the Efficacy of the hematoma block for reduction in distal forearm fractures Design: Double Blind Randomized Control Trial Setting: Tertiary care Hospital Patients/Participants: The patients having radiologically confirmed distal forearm fractures less than 96 hours old in 100 patient (46 males and 54 females) included after giving informed consent Intervention : 50 patients receiving Brachial Plexus Block (BPB group), and 50 patients receiving Hematoma Block (HB group) during reduction of distal forearm fractures, Main Outcome Measurements: Pain measured by Visual Analogue Scale (VAS) was recorded before, during, and after reduction. Results: The study showed that Hematoma block with (mean ± SD) VAS scores of 2.08 ± 0.85 was as effective as Brachial Plexus mean± SD VAS=1.7 ± 0.64 in term of producing analgesia, p=0.013 with the advantage of no motor paralysis and a significantly higher reduction rate, odds 3.45, 95% CI 1.52 -7.85. 1/50 patients in brachial plexus block had bronchospasm needing intubation and ICU care where as 1/50 patient with hematoma block and infection which needed incision drainage and external fixation for complete healing. Conclusions: Visual Analogue Scale during reduction in both the groups was comparable meaning that pain relief during reduction was not significantly different in both the groups. The Quality of reduction was found to be more in the HB group than the BPB group thereby meaning the chances of the perfect reduction in the HB group is three times higher than that of the reduction in the BPB group.