Hematoma Block for Wrist Fractures
(Hematoma Block Trial)
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Beth Israel Deaconess Medical Center
Disqualifiers: High distress, Intoxication, Dementia, others
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?The purpose of this study is to determine the efficacy of ultrasound guided hematoma block versus traditional "blind" hematoma block for analgesia in distal radius fracture reduction.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Ultrasound Guided Hematoma Block for wrist fractures?
Research shows that ultrasound-guided hematoma blocks are effective for pain control and fracture reduction in forearm and sternal fractures, suggesting they may also be effective for wrist fractures. This method is considered faster and as effective as sedation, with rare complications.
12345Is a hematoma block for wrist fractures safe?
Hematoma blocks are generally considered safe and effective for pain relief in wrist fractures, but rare complications can occur, such as short-term neurological symptoms due to the absorption of the anesthetic.
12345How is the ultrasound-guided hematoma block treatment for wrist fractures different from other treatments?
The ultrasound-guided hematoma block is unique because it uses ultrasound to precisely guide the injection of local anesthesia directly into the fracture site, providing effective pain relief without the need for sedation or general anesthesia, which is typically required for fracture reduction.
23456Eligibility Criteria
This trial is for adults over 18 who come to the emergency department with a distal radius fracture, which is a type of broken bone near the wrist. It's not specified who can't join, but typically those with additional health complications might be excluded.Inclusion Criteria
I am over 18 and went to the ER for a wrist fracture.
Exclusion Criteria
High acuity/distress per the Attending ED physician
Altered mental status or intoxication
Aphasia, mental retardation, dementia, or insurmountable communication barrier
+1 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
1 week
Treatment
Participants receive either a traditional or ultrasound-guided hematoma block for analgesia in distal radius fracture reduction
1 day
1 visit (in-person)
Follow-up
Participants are monitored for pain reduction and safety after the procedure
4 hours
Participant Groups
The study aims to compare two methods of pain relief during bone setting: one using an ultrasound guide (a device that helps visualize inside the body) and the traditional method without visual aid.
2Treatment groups
Experimental Treatment
Active Control
Group I: ultrasound-guided hematoma blockExperimental Treatment1 Intervention
Patients in this arm will receive a bed-side ultrasound guided hematoma block with analgesia (0.25% bupivacaine)
Group II: traditional hematoma blockActive Control1 Intervention
Patients in this arm will have the hematoma block of the distal radius fracture with no ultrasound for guidance with analgesia (0.25% bupivacaine)
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Beth Israel Deaconess Medical CenterBoston, MA
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Who Is Running the Clinical Trial?
Beth Israel Deaconess Medical CenterLead Sponsor
Harvard UniversityCollaborator
References
Pain control for sternal fracture using an ultrasound-guided hematoma block. [2016]In this case report, an ultrasound-guided hematoma block was performed in the Emergency Department (ED) for immediate and effective pain control in a patient suffering from a sternal fracture. This technique of anesthesia may allow safer and more effective analgesia and a more rapid discharge from the hospital or ED in selected cases.
Ultrasound-Guided Nerve Blocks as Analgesia for Nonoperative Management of Distal Radius Fractures-Two Consecutive Randomized Controlled Trials. [2020]To investigate whether a conventional fracture hematoma block (FHB) or an ultrasound-guided peripheral nerve block has more superior analgesic effect during nonoperative management of distal radius fractures in an emergency department setting. Two peripheral nerve block types were investigated, one at the level of the elbow, or cubital nerve block (CNB), and another an axillary nerve block (ANB).
Point-of-Care Ultrasound-Guided Hematoma Block for Forearm Fracture Reduction. [2023]Fractures of the radius and ulna are very common in pediatric patients. Procedural sedation or general anesthesia is typically required to perform orthopedic reductions. There are several studies in the adult literature that conclude that point-of-care ultrasound-guided hematoma blocks are faster and just as efficacious as procedural sedation for reducing fractures in the emergency department. There is currently no literature examining point-of-care ultrasound-guided hematoma blocks in pediatric patients. This case describes a pediatric patient with a distal radius fracture who underwent a hematoma block under ultrasound guidance and had a successful bedside reduction without the need for sedation.
Ultrasound-guided hematoma block for distal radial and ulnar fractures. [2022]Hematoma blocks of the radius can provide excellent analgesia for simple distal radius fractures. However, the landmark-based approach can be difficult, and ultrasound guidance may improve success of the block and analgesia during reduction. There is limited literature describing the ultrasound-guided approach, and prior case descriptions have not involved comminuted fractures or concomitant ulnar styloid fractures.
A Hematoma Block in the Wrist for a Displaced Distal Radius Fracture Induces Systemic Neurological Symptoms: A Case Report. [2023]Hematoma blocks are considered a relatively simple, safe, and effective technique in the acute setting to provide sufficient anesthesia and allow for closed reduction of displaced distal radius fractures. Complications associated with the utilization of local anesthetics in this setting are rare. We present the case of a patient who had a hematoma block in the wrist and developed short-term systemic neurologic complications likely secondary to systemic absorption of 20 mL of 1% lidocaine without epinephrine via the cancellous bone channels.
Distal Radius Fracture Hematoma Block with Combined Lidocaine and Bupivacaine can induce Seizures while within Therapeutic Window: A Case Report. [2020]Hematoma blocks are effective pain management modalities for closed reduction of distal radius fractures. Complications of hematoma blocks are associated with systemic reaction to anesthetic used.