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The purpose of this study is to compare different types of local anesthesia-a supracondylar radial nerve block, a hematoma block, or a combination of the two-for reducing pain in people with a broken wrist (distal radius fracture). This is being done to find out which method provides better pain relief after the injury and during treatment in the emergency room.
This study is testing different ways to provide pain relief before reducing a broken wrist. Participants will receive one of three techniques: (1) a nerve block where a doctor injects lidocaine near the radial nerve under ultrasound guidance; (2) a hematoma block where a doctor injects lidocaine into the area where the bone broke; or (3) both the nerve block and the hematoma block. Patients will be asked how much pain they feel before the numbing, after the numbing, and after the wrist is reduced.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Supracondylar radial nerve blocks | Experimental | Lidocaine injection given near the radial never under ultrasound guidance |
|
| Hematoma blocks | Experimental | Injecting analgesia into the hematoma that forms surrounding the wrist fracture |
|
| Combination of supracondylar radial nerve block and hematoma block | Experimental | Supracondylar radial nerve block given first followed by hematoma block |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Supracondylar radial nerve block | Procedure | Supracondylar radial nerve blocks given at the radial nerve not as the same location of the fracture site, prior to fracture reduction. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain levels comparison | Comparing pain levels among patients who are undergoing a wrist fracture reduction. Measured on a scale of 0-10, 0= no pain to 10= worst pain. Pain will be measured at (1) baseline, (2) after administering the assigned pain block (s), and after the (3) fracture reduction. | Pain will be measured at (1) baseline, (2) after administering the assigned pain block(s), and after the (3) fracture reduction. |
| Measure | Description | Time Frame |
|---|---|---|
| Amount of opioid medication needed to control pain. | The amount of opioid prescribed, if any, will be collected and recorded for comparison during patient's time in emergency room. | Opioid medication prescribing will be assessed at baseline, time of admission to the emergency room, until the patient is discharged and they are no longer active in the study. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aaron Grossberg, DO | Sarasota Memorial Health Care System | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sarasota Memorial Health Care System | Sarasota | Florida | 34239 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29580286 | Background | Tseng PT, Leu TH, Chen YW, Chen YP. Hematoma block or procedural sedation and analgesia, which is the most effective method of anesthesia in reduction of displaced distal radius fracture? J Orthop Surg Res. 2018 Mar 27;13(1):62. doi: 10.1186/s13018-018-0772-7. | |
| 30893220 | Background | Siebelt M, Hartholt KA, van Winden DFM, Boot F, Papathanasiou D, Verdouw BC, de Vries MR, Mathijssen NM, Kraan GA. Ultrasound-Guided Nerve Blocks as Analgesia for Nonoperative Management of Distal Radius Fractures-Two Consecutive Randomized Controlled Trials. J Orthop Trauma. 2019 Apr;33(4):e124-e130. doi: 10.1097/BOT.0000000000001388. |
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The purpose of this study is to compare different types of local anesthesia-a supracondylar radial nerve block, a hematoma block, or a combination of the two-for lowering pain in people with a broken wrist (distal radius fracture). We want to find out which method provides better pain relief after the injury and during treatment in the emergency room. Each of these methods is a different standard procedure for pain control prior to wrist fracture reduction.
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| Hematoma block | Procedure | Injection of analgesia into the hematoma that forms surrounding the wrist fracture. |
|
| Combination of blocks | Procedure | Supracondylar radial nerve block given first, followed by hematoma block, before fracture reduction. |
|
| Number of patients requiring conscious sedation. | The need for conscious sedation among patients undergoing wrist fracture reduction in emergency care center will be recorded and monitored for comparison between groups. | Patients will be monitored for need of conscious sedation from baseline, time of enrollment in the study, until discharge from the emergency room, when they are no longer active in the study. |
| Adverse Events Monitoring | Adverse events associated with any of the blocks that are administered to patients undergoing a wrist fracture reduction in the emergency care center will be identified, monitored, and recorded for reporting. | From baseline, time the patient is admitted and enrolled into the study, until the patient is discharged and no longer active in the study. |
| 36239973 | Background | Oakley B, Busby C, Kulkarni S, Arnold SJ, Kulkarni SS, Ollivere BJ. Manipulation of distal radius fractures: a comparison of Bier's block vs haematoma block. Ann R Coll Surg Engl. 2023 May;105(5):434-440. doi: 10.1308/rcsann.2022.0116. Epub 2022 Oct 14. |
| 37663190 | Background | Maia GAS, Cunha JC, Feijo CQ, Leal DM, Moreira JJ, Herrero CFPDS. Radial Nerve Supracondylar Block Versus Fracture Hematoma Block. Comparison of Their Efficacy in Cases of Fractures of the Distal Third of the Radius. Rev Bras Ortop (Sao Paulo). 2023 Aug 30;58(4):e557-e562. doi: 10.1055/s-0043-1768623. eCollection 2023 Aug. |
| 12137688 | Background | Handoll HH, Madhok R, Dodds C. Anaesthesia for treating distal radial fracture in adults. Cochrane Database Syst Rev. 2002;2002(3):CD003320. doi: 10.1002/14651858.CD003320. |
| 37527380 | Background | Haley CB, Beauchesne AR, Fox JC, Nelson AM. Block Time: A Multispecialty Systematic Review of Efficacy and Safety of Ultrasound-guided Upper Extremity Nerve Blocks. West J Emerg Med. 2023 Jun 30;24(4):774-785. doi: 10.5811/westjem.56058. |
| 25497895 | Background | Gottlieb M, Cosby K. Ultrasound-guided hematoma block for distal radial and ulnar fractures. J Emerg Med. 2015 Mar;48(3):310-2. doi: 10.1016/j.jemermed.2014.09.063. Epub 2014 Dec 9. |
| 39399762 | Background | Martinez-Arboleda JJ, Moreno M, Diaz-Solorzano JP, Mejia-Grueso A. Ultrasound-guided supracondylar radial nerve block for closed reduction of a distal radius fracture in the emergency department: Case report. Trauma Case Rep. 2024 Sep 25;54:101116. doi: 10.1016/j.tcr.2024.101116. eCollection 2024 Dec. |
| 40615307 | Background | Che Daud AZ, Mohd Nayan NA, Ahmad A, Alrashdi M, Kadar M, Mohd Poot EF. Distal radius fracture rehabilitation: A bibliometric and scoping review. J Hand Ther. 2026 Jan-Mar;39(1):120-132. doi: 10.1016/j.jht.2025.05.016. Epub 2025 Jul 4. |
| 38145179 | Background | Abbasi S, Garjani N, Mahshidfar B, Farsi D, Mofidi M, Hafezimoghadam P, Rezai M, Javan A. Comparative Study of Radial and Median Nerve Blocks with Hematoma Block under Ultrasound Guide in Distal Radius Fracture Reduction: A Randomized Clinical Trial. Med J Islam Repub Iran. 2023 Oct 23;37:113. doi: 10.47176/mjiri.37.113. eCollection 2023. |
| ID | Term |
|---|---|
| D000092503 | Wrist Fractures |
| D050723 | Fractures, Bone |
| ID | Term |
|---|---|
| D014954 | Wrist Injuries |
| D001134 | Arm Injuries |
| D014947 | Wounds and Injuries |
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