Kehinde Adesola Alatishe1,2, Lukman Olalekan Ajiboye3,4, Chungjoe Choji5,6, Olatunji Sulaimon Olanrewaju7, Wakeel Olaide Lawal8. 1. Orthopaedic and Trauma Department, National Orthopaedic Hospital, 120/124 Ikorodu road, Lagos, Nigeria. medistuff1@yahoo.com. 2. National Orthopaedic Hospital, Lagos, Nigeria. medistuff1@yahoo.com. 3. Orthopaedic and Trauma Department, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. 4. Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. 5. Trauma Unit, Orthopaedic and Trauma Department, National Orthopaedic Hospital, 120/124 Ikorodu road, Lagos, Nigeria. 6. National Orthopaedic Hospital, 120/124 Ikorodu road, Lagos, Nigeria. 7. Department of Hospital Services, Federal Ministry of Health, Abuja, Nigeria. 8. Orthopaedic and Trauma Department, National Orthopaedic Hospital, 120/124 Ikorodu road, Lagos, Nigeria.
Abstract
OBJECTIVE: We compared the radiographic quality of initial reduction of distal radius fractures reduced using haematoma block to those reduced with intravenous sedation. The overall rate of re-manipulation and complications were noted. METHODS: A prospective study carried out at the emergency unit of our hospital between 1st September, 2017 and 31st December, 2018. Patients were consecutively recruited into Haematoma Block (HB) and Sedation(S) groups using the simple balloting method. After 5-10 min of administering anaesthesia, the fracture was reduced and immobilized in a below-to-elbow Plaster of Paris (P.O.P) cast for 6 weeks. The pre- and post-reduction radiographs were reviewed for volar tilt, radial angulation, radial deviation and radial shortening. RESULTS: Sixty-seven patients completed the study with 33 patients in HB group and 34 patients in S group. There was no significant difference in the radiographic quality of initial reduction between the two groups using the Sarmiento's modification of Lindström criteria (p = 0.49). Five out of 34 patients among the sedated group had gastrointestinal symptoms. The overall rate of re-manipulation was low and the complications recorded were wrist stiffness and residual wrist deformity. CONCLUSION: Our study revealed that there was no significant difference in the radiographic quality of initial reduction between the groups. Excellent to good reduction was achieved with both anaesthetic options. The choice of anaesthesia should be individualized and based on surgeons' preference.
OBJECTIVE: We compared the radiographic quality of initial reduction of distal radius fractures reduced using haematoma block to those reduced with intravenous sedation. The overall rate of re-manipulation and complications were noted. METHODS: A prospective study carried out at the emergency unit of our hospital between 1st September, 2017 and 31st December, 2018. Patients were consecutively recruited into Haematoma Block (HB) and Sedation(S) groups using the simple balloting method. After 5-10 min of administering anaesthesia, the fracture was reduced and immobilized in a below-to-elbow Plaster of Paris (P.O.P) cast for 6 weeks. The pre- and post-reduction radiographs were reviewed for volar tilt, radial angulation, radial deviation and radial shortening. RESULTS: Sixty-seven patients completed the study with 33 patients in HB group and 34 patients in S group. There was no significant difference in the radiographic quality of initial reduction between the two groups using the Sarmiento's modification of Lindström criteria (p = 0.49). Five out of 34 patients among the sedated group had gastrointestinal symptoms. The overall rate of re-manipulation was low and the complications recorded were wrist stiffness and residual wrist deformity. CONCLUSION: Our study revealed that there was no significant difference in the radiographic quality of initial reduction between the groups. Excellent to good reduction was achieved with both anaesthetic options. The choice of anaesthesia should be individualized and based on surgeons' preference.
Authors: Steven A Godwin; David A Caro; Stephen J Wolf; Andy S Jagoda; Ronald Charles; Benjamin E Marett; Jessie Moore Journal: Ann Emerg Med Date: 2005-02 Impact factor: 5.721