Brachial Plexus Block, Distal Radius Fracture, Hematoma Block
Conditions
Keywords
Brachial Plexus Block, Distal Radius Fracture, Hematoma Block
Brief summary
Distal radius fractures are one of the most common types of fractures, affecting mostly youngsters and the elderly. Safety, ease of use, affordability, and effectiveness all play a role in analgesia during reduction. This study's goal is to assess how well the Hematoma Block (HB) reduces distal forearm fractures in a developing nation like Nepal. At a tertiary care hospital, a randomized comparative study is used. The individuals with distal forearm fractures that have been radiologically confirmed are enrolled after taking informed consent. When reducing distal forearm fractures, the patients are divided into two groups: Brachial Plexus Block (BPB group) and Hematoma Block group. We note the level of pain before, during, and after reduction using the Visual Analogue Scale (VAS) in both groups. The patient's radiological correction is assessed by Modified Sarmiento Criteria with an immediate post reduction radiograph. Comparing Hematoma Block and Brachial Plexus Block, we can choose a definitive easy method for reduction that is easy, safe and less time consuming. Hence, the study will provide a guide for commonly occurring distal radius fracture. Hypotheses of the Study: Null hypothesis (Ho): There is no difference between feasibility, safety and quality of reduction in the two groups of anesthesia techniques. Ho: Safety, efficacy and quality of reduction with Hematoma block = Brachial plexus block Alternate hypothesis (H1): There is a difference between feasibility, safety and quality of reduction in the two groups of anesthesia techniques. H1: Safety, efficacy and quality of reduction with Hematoma block ≠ Brachial plexus block
Interventions
PROCEDUREBrachial Plexus Block
Ultrasound-guided regional anesthesia administered by anesthesiology personnel
PROCEDUREHematoma Block
Local anesthetic infiltration into the fracture hematoma by an orthopedic surgeon/resident.
Sponsors
Kathmandu University School of Medical Sciences
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adult male or female patients in the age range of skeletally mature (18 years and above) 2. Displaced distal radius fracture, requiring manipulation 3. Only extra-articular fractures.
Exclusion criteria
1. Open fractures (Gustilo Anderson open fracture Type I, II and III), intra-articular fractures, and comminuted fractures. 2. Undisplaced distal radial fractures which do not require manipulation. 3. Patients who have a history of an adverse reaction to local anesthetics. 4. Polytrauma, multiple injuries
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Severity Assessed by Visual Analogue Scale (VAS) | 1 year | Pain severity during fracture reduction will be assessed using the Visual Analogue Scale (VAS), a 10-point scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates worst imaginable pain. Pain scores will be recorded prior to, during, and immediately following fracture reduction. Higher scores indicate worse pain severity. |
| Quality of Fracture Reduction Assessed by Plain Radiographic Parameters | 1 year | Quality of reduction following fracture manipulation will be assessed using plain radiographs in posteroanterior (PA) and lateral views. Radiographic parameters include ulnar variance (mm), radial length (mm), radial tilt (degrees), and dorsal/palmar tilt (degrees). Measurements will be compared between hematoma block and brachial plexus block groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Procedure-Related Complications | 1 year | Complications related to fracture reduction or anesthesia technique will be recorded during hospital stay and follow-up. Complications may include neurovascular injury, compartment syndrome, local anesthetic-related adverse events, infection, or failure of reduction. Outcome will be reported as number and percentage of participants experiencing complications. |
Countries
Nepal
Outcome results
None listed