A prospective randomized trial comparing the effect of two different methods of anesthesia for reduction of displaced distal radius fractures; haematoma block versus peripheral nerve block at the elbow

Fracture of the distal radius is a common clinical problem, particularly in
older white women with osteoporosis. For patients with a displaced distal
radius fracture, fracture reduction is the first step in management of these
injuries. Anaesthesia is usually provided during reduction of displaced
fractures; different methods of anesthesia are used in clinical practice.
Current literature offers no strong evidence to support either of the different
techniques (general anesthesia excluded) in providing best analgesia during
fracture reduction. We think that regional nerve block at the elbow provides
equal or better analgesia compared to haematoma block anesthesia.

To compare the effect of two different methods of anesthesia on painsensation
(VAS score) during fracture reduction.

A prospective randomised controlled trial, comparing two different methods of
anesthesia

Two different methods of anesthesia (no general anesthesia): local anesthesia
with haematoma block around the fracture or regional nerve blocking anesthesia
at the level of the elbow

The two different intervention methods of anesthesia within this study are both
used in general practice. Haematoma block could cause a headache wich will
disappear in time. Regional nerve blocking in the elbow could cause a headache
aswell when the anesthetic material is injected in a arterial or venous
bloodvessel. Theorethically, damage to the nerves is possible if the anesthetic
material is injected dirtectly into the nerve. This is unlikely to happen,
because patients will feel pain of strange feeling in their fingers when the
needle enters the nerve; the doctor will change the position of the needle
before injection of the anesthetic material.
Patients in this study will not visit the hospital more frequently then
patients who are not participating within this study. The outpatient control
moment after one week could take 5 minutes more of the patients time. Also, the
doctor will call the patient once to ask for painsensation at that moment. The
regular management of the wrist fracture does not change by participating
within this study.