There was insufficient robust evidence from randomised trials to establish the relative effectiveness of different methods of anaesthesia, different associated physical techniques or the use of drug adjuncts in the treatment of distal radial fractures. There is, however, some indication that haematoma block provides poorer analgesia than IVRA, and can compromise reduction.
Given the many unresolved questions over the management of these fractures, we suggest an integrated programme of research, which includes consideration of anaesthesia options, is the way forward.
Regional anesthesia preferable for Colles' fracture. Controlled comparison with local anesthesia.
In a prospective randomized study of 99 displaced Colles' fractures, regional intravenous block was compared with local anesthesia in the fracture hematoma. Patients treated with regional intravenous block had less pain during the manipulation of the fracture and better grip strength at the 6-month follow-up. The anatomic end result (dorsal angulation) was better after regional anesthesia.