HEMATOMA BLOCK FOR ANKLE FRACTURES - A SAFE AND EFFICACIOUS TECHNIQUEFOR MANIPULATIONS

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.