Abstract :
Objective: To describe the outcome of hematoma block local anesthesia for closed reduction of Colles-type fractures in emergency care setting. Methodology: This descriptive study was conducted at Khalifa Gul Nawaz Teaching Hospital & District Headquarters Teaching Hospital Bannu, from February 2009 to August 2010. A total of 70 patients having Colles-type fractures were recruited for this study. Closed reduction and plaster casting was performed under HB in Accident & Emergency Department. Pre- and post-reduction radiographic assessment was done. A questionnaire about pain perception was administered to patients. It included a visual analogue scale as well. Fractures requiring re-manipulation were noted. Any local or systemic complications of anesthesia were recorded. Patients were sent home 3 hours after reduction. Follow-up of the patients was done up to 12 weeks. Results: Out of 70 patients, 30 were males & 40 were females. They were in the age range of 20-80years. On assessing their pain perception with VAS, during closed reduction under HB, 36 patients had no pain, 24 had mild pain, 6 were feeling moderate pain, and 4 were feeling severe pain. 12 patients required re-manipulation for improper reduction. 2 patients developed carpal tunnel syndrome, 3 developed reflex sympathetic dystrophy & one developed localized infection at the site of infiltration. No systemic complications of anesthesia were noted. Conclusion: HB can be used effectively for closed reduction of Colles-type fractures, especially in a district hospital which lacks advanced anesthesia and intensive care facilities.
