Abstract：
BACKGROUND: Two out of three wrist fractures seen in an emergency department are displaced but most can be treated conservatively after closed reduction. Patient-reported pain during closed reduction of distal radius fractures varies widely and the best method to decrease the perceived pain has not been well established. The purpose of this study was to assess pain during closed reduction of distal radius fractures after using haematoma block as method of anaesthesia.
METHODS: Cross-sectional clinical study including all patients who presented an acute fracture of the distal radius requiring closed reduction and immobilisation during a six-month period in two University Hospitals. Demographic data, fracture classification, perceived pain using a visual analogue scale at different times of reduction and complications were registered.
RESULTS: Ninety-four consecutive patients were included. Mean age was 61 years. Mean pain score at initial assessment was 6 points. After the haematoma block, the perceived pain during the reduction manoeuvre improved to 5.1 points at the wrist, but increased to 7.3 points at the fingers. Pain decreased to 4.9 points during cast placement and reached 1.4 point after sling placement. The reported pain was higher in women at all times. There were no significant differences according to the according to the type of fracture. No neurological or skin complications were observed.
CONCLUSIONS: Haematoma block is only a mildly effective method to reduce wrist pain during closed reduction of distal radius fractures. This technique slightly decreases the perceived pain in the wrist and does not reduce the pain in the fingers. Other reduction methods or other analgesic techniques may be more effective options.
METHODS: Therapeutic study. Cross-sectional study - Level IV.
METHODS: Cross-sectional clinical study including all patients who presented an acute fracture of the distal radius requiring closed reduction and immobilisation during a six-month period in two University Hospitals. Demographic data, fracture classification, perceived pain using a visual analogue scale at different times of reduction and complications were registered.
RESULTS: Ninety-four consecutive patients were included. Mean age was 61 years. Mean pain score at initial assessment was 6 points. After the haematoma block, the perceived pain during the reduction manoeuvre improved to 5.1 points at the wrist, but increased to 7.3 points at the fingers. Pain decreased to 4.9 points during cast placement and reached 1.4 point after sling placement. The reported pain was higher in women at all times. There were no significant differences according to the according to the type of fracture. No neurological or skin complications were observed.
CONCLUSIONS: Haematoma block is only a mildly effective method to reduce wrist pain during closed reduction of distal radius fractures. This technique slightly decreases the perceived pain in the wrist and does not reduce the pain in the fingers. Other reduction methods or other analgesic techniques may be more effective options.
METHODS: Therapeutic study. Cross-sectional study - Level IV.
摘要：
背景：在急诊科看到的三个腕部骨折中有两个移位，但大多数可以在闭合复位后保守治疗。患者报告的桡骨远端骨折闭合复位过程中的疼痛差异很大，并且尚未确定减轻感知疼痛的最佳方法。这项研究的目的是评估使用血肿阻滞作为麻醉方法后桡骨远端骨折闭合复位过程中的疼痛。
方法：横断面临床研究，包括在两个大学医院进行的6个月期间所有桡骨远端急性骨折需要闭合复位和固定的患者。人口统计数据,断裂分类,使用视觉模拟量表在不同时间的减轻和并发症记录了感觉到的疼痛.
结果：纳入94例连续患者。平均年龄为61岁。初始评估时的平均疼痛评分为6分。血肿阻滞后,在复位操作期间感觉到的疼痛改善到手腕处的5.1点，但增加到7.3分的手指。放置石膏时疼痛降低至4.9分，放置吊带后疼痛降低至1.4分。报告的疼痛在任何时候都是女性。根据骨折类型差异无统计学意义。未观察到神经或皮肤并发症。
结论：血肿阻滞仅是减轻桡骨远端骨折闭合复位时腕关节疼痛的一种温和有效的方法。该技术略微减少了手腕的感知疼痛，并且不会减少手指的疼痛。其他减少方法或其他镇痛技术可能是更有效的选择。
方法：治疗性研究。横断面研究-IV级。
方法：横断面临床研究，包括在两个大学医院进行的6个月期间所有桡骨远端急性骨折需要闭合复位和固定的患者。人口统计数据,断裂分类,使用视觉模拟量表在不同时间的减轻和并发症记录了感觉到的疼痛.
结果：纳入94例连续患者。平均年龄为61岁。初始评估时的平均疼痛评分为6分。血肿阻滞后,在复位操作期间感觉到的疼痛改善到手腕处的5.1点，但增加到7.3分的手指。放置石膏时疼痛降低至4.9分，放置吊带后疼痛降低至1.4分。报告的疼痛在任何时候都是女性。根据骨折类型差异无统计学意义。未观察到神经或皮肤并发症。
结论：血肿阻滞仅是减轻桡骨远端骨折闭合复位时腕关节疼痛的一种温和有效的方法。该技术略微减少了手腕的感知疼痛，并且不会减少手指的疼痛。其他减少方法或其他镇痛技术可能是更有效的选择。
方法：治疗性研究。横断面研究-IV级。
