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Periosteal nerve blocks for distal radius and ulna fracture manipulation--the technique and early results.

Tageldin ME, Alrashid M, Khoriati AA, Gadikoppula S, Atkinson HD - J Orthop Surg Res (2015)

Bottom Line: The procedure was described as painless in 35 (83%) patients (visual analogue scale/VAS score 0), with 6 (14%) suffering minimal pain (VAS 1-3).No additional analgesia of any kind was given.Local anaesthetic periosteal nerve blocks injected proximally to the fracture sites are a simple and yet very effective new technique which provide good/excellent analgesia and facilitate the reduction of distal radial and ulnar fractures.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Orthopaedics, North Middlesex University Hospital, London, N18 1QX, UK. mohamed.tageldin@sky.com.

ABSTRACT

Background: We present a pilot series of patients with distal forearm fractures manipulated following a proximal periosteal nerve block with local anaesthesia. This is a novel technique which can be utilised in adults and children and is described herein.

Methods: With a median of 40 years (range 10-81 years), 42 patients (16 children) with distal radial and ulnar fractures were included. Of these patients, 40 underwent periosteal blocks in the emergency room or fracture clinic; 2 were already inpatients. Fractures were manipulated routinely and immobilised with plaster. Mobile fluoroscopy was not used for patients in the emergency department or fracture clinic.

Results: Of the 42 patients, 40 patients (95%) had successful fracture manipulation and did not require subsequent treatment. Two patients (5%) needed subsequent surgery, one for K-wire stabilisation of their fracture and the second for volar plate fixation. The procedure was described as painless in 35 (83%) patients (visual analogue scale/VAS score 0), with 6 (14%) suffering minimal pain (VAS 1-3). In the 12-16-year age group, 15 patients (94%) described the manipulation as painless; 1 patient described the procedure as minimally painful. No additional analgesia of any kind was given. There were no direct complications from any of the periosteal nerve blocks.

Conclusions: Local anaesthetic periosteal nerve blocks injected proximally to the fracture sites are a simple and yet very effective new technique which provide good/excellent analgesia and facilitate the reduction of distal radial and ulnar fractures.

No MeSH data available.


Related in: MedlinePlus

Pre- and post-manipulation radiographs of an 11-year-old boy with a left distal forearm fracture
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Fig5: Pre- and post-manipulation radiographs of an 11-year-old boy with a left distal forearm fracture

Mentions: All patients were followed up to bony and clinical fracture union. FiguresĀ 4, 5, 6, 7, 8, 9 and 10 show radiographs of two patients.Fi g. 4


Periosteal nerve blocks for distal radius and ulna fracture manipulation--the technique and early results.

Tageldin ME, Alrashid M, Khoriati AA, Gadikoppula S, Atkinson HD - J Orthop Surg Res (2015)

Pre- and post-manipulation radiographs of an 11-year-old boy with a left distal forearm fracture
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4557923&req=5

Fig5: Pre- and post-manipulation radiographs of an 11-year-old boy with a left distal forearm fracture
Mentions: All patients were followed up to bony and clinical fracture union. FiguresĀ 4, 5, 6, 7, 8, 9 and 10 show radiographs of two patients.Fi g. 4

Bottom Line: The procedure was described as painless in 35 (83%) patients (visual analogue scale/VAS score 0), with 6 (14%) suffering minimal pain (VAS 1-3).No additional analgesia of any kind was given.Local anaesthetic periosteal nerve blocks injected proximally to the fracture sites are a simple and yet very effective new technique which provide good/excellent analgesia and facilitate the reduction of distal radial and ulnar fractures.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma and Orthopaedics, North Middlesex University Hospital, London, N18 1QX, UK. mohamed.tageldin@sky.com.

ABSTRACT

Background: We present a pilot series of patients with distal forearm fractures manipulated following a proximal periosteal nerve block with local anaesthesia. This is a novel technique which can be utilised in adults and children and is described herein.

Methods: With a median of 40 years (range 10-81 years), 42 patients (16 children) with distal radial and ulnar fractures were included. Of these patients, 40 underwent periosteal blocks in the emergency room or fracture clinic; 2 were already inpatients. Fractures were manipulated routinely and immobilised with plaster. Mobile fluoroscopy was not used for patients in the emergency department or fracture clinic.

Results: Of the 42 patients, 40 patients (95%) had successful fracture manipulation and did not require subsequent treatment. Two patients (5%) needed subsequent surgery, one for K-wire stabilisation of their fracture and the second for volar plate fixation. The procedure was described as painless in 35 (83%) patients (visual analogue scale/VAS score 0), with 6 (14%) suffering minimal pain (VAS 1-3). In the 12-16-year age group, 15 patients (94%) described the manipulation as painless; 1 patient described the procedure as minimally painful. No additional analgesia of any kind was given. There were no direct complications from any of the periosteal nerve blocks.

Conclusions: Local anaesthetic periosteal nerve blocks injected proximally to the fracture sites are a simple and yet very effective new technique which provide good/excellent analgesia and facilitate the reduction of distal radial and ulnar fractures.

No MeSH data available.


Related in: MedlinePlus