Rj. Alioto et al., HEMATOMA BLOCK FOR ANKLE FRACTURES - A SAFE AND EFFICACIOUS TECHNIQUEFOR MANIPULATIONS, Journal of orthopaedic trauma, 9(2), 1995, pp. 113-116
The purpose of this study was to examine the safety and efficacy of th
e hematoma block technique for closed ankle fracture manipulation. Twe
nty-three patients received a hematoma block with or without supplemen
tal analgesia and/or sedation for the manipulative reduction of an ank
le fracture, and 37 patients received parenteral agents alone. At an a
verage of 12 months post-reduction, patients were administered a quest
ionnaire concerning their level of discomfort surrounding the manipula
tion of their acute injury. Their experienced level of pain was record
ed on a pain analog scale at the time of injury, at the time of reduct
ion, and at the time of the questionnaire. Other queries were made reg
arding their recall of other aspects of their acute care treatment. Th
e hematoma block group noted their pain differential to be 3.4 less du
ring reduction compared with the time of injury. In the 17% subgroup o
f hematoma block patients who received no supplemental parenteral anal
gesia, the pain differential was noted to be 4.5 less during reduction
. This was in contrast to the non-hematoma block group, which rated th
eir pain differential to be 0.6 between injury and reduction. In addit
ion, the hematoma block procedure resulted in no associated complicati
ons. The results of this study led us to conclude that the hematoma bl
ock with or without supplemental analgesia for the manipulation of ank
le fractures was safe and effective and is a useful technique. This is
particularly true in those patients in whom an adequate dosage of par
enteral medication is contraindicated or unsafe.