Journal
SWISS MEDICAL WEEKLY
Volume 150, Issue -, Pages -Publisher
E M H SWISS MEDICAL PUBLISHERS LTD
DOI: 10.4414/smw.2020.20288
Keywords
distal radius fracture; forearm fracture; ultrasound guided regional anaesthesia; ultrasound guided reposition; emergency department; pain management
Categories
Funding
- scientific funds of the Emergency Department of the University Hospital Basel
Ask authors/readers for more resources
OBJECTIVES: Distal radius fractures are among the most common fractures. Ultrasound is gaining importance in the treatment of and as a tool to diagnose distal radius fractures, guide regional anaesthesia and support reductions. Our aim was to demonstrate safety, feasibility and outcome in patients with a distal radius fractures undergoing ultrasound-guided regional anaesthesia (UGRA) with ultrasound-guided reduction (UGR), as compared with procedural sedation for the reduction. METHODS: This retrospective cohort study was carried out in the emergency department of the University Hospital Basel (Switzerland) between February 2014 and October 2017. Adults with an isolated forearm fracture were eligible. The intervention group was treated with UGRA of the brachial plexus and subsequent ultrasound-assisted fracture reduction. Patients in the control group received usual care, which is blind fracture reduction with extension and immobilisation under procedural sedation. RESULTS: 71 patients were enrolled in the intervention group and 142 were to the control group. There was one (1.4%) complication (pneumothorax) in the UGR group. Twenty-five patients (35%) in the intervention group and 67 patients (47%) in the control group underwent surgery. The association between surgery and study group was not significant (p = 0.08). The patient's age was negatively associated with surgery (p < 0.001). The association between surgery and study group was significant in patients >= 60 years (p = 0.035). CONCLUSION: The combination of ultrasound-guided regional anaesthesia and ultrasound-guided reduction of distal radius fractures is feasible. Safety was shown by 70 out of 71 cases of UGRA being without complication. Effectiveness regarding the necessity of subsequent operation was comparable to usual care; in patients over 60 it may be lower with UGR.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available