Ultrasound Guided Hematoma Block in Distal Forearm Fractures

Study Overview
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Brief Summary
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This is a randomized control trial comparing the efficacy of ultrasound (US) guided vs landmark-guided hematoma blocks on distal forearm fractures.

Official Title
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Ultrasound Guided vs Landmark-based Hematoma Block in Distal Forearm Fractures

Conditions
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Forearm Fracture

Intervention / Treatment
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* Device: Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients greater than and equal to seven years of age Patients with traumatic acute distal radius/ulnar fractures with displacement that require reduction and immobilization with splinting Patients that receive distal radius hematoma blocks, including those who require additional pain control adjuncts if pain control is not adequate Exclusion Criteria: Prisoners Pregnant women Patients with altered mental status/have impaired decision-making capacity. Patients with allergies to amide anesthetics

Ages Eligible for Study
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Minimum Age: 7 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Study Intervention Group (Ultrasound)<br>The ultrasound probe will be used for real-time needle and hematoma localization using the linear probe. The hematoma block will then be performed with aseptic technique. The skin will be prepped with chlorhexidine. A 20-gauge needle will be inserted in-plane into the hematoma site. A small amount of blood will be aspirated to confirm placement and 5-10 mL of 1% lidocaine will be infiltrated. | Device: Ultrasound<br>* The ultrasound will be used to assist with the delivery of a hematoma block in patients with distal forearm fractures.<br>|
| No Intervention: Study Control Group (Landmark)<br>The ultrasound probe will be in place on the patient's arm to maintain single blinding of the study. The ultrasound machine will not be used for needle and hematoma localization. The hematoma block will then be performed with aseptic technique. The skin will be prepped with chlorhexidine. A 20-gauge needle will be inserted in-plane into the hematoma site. A small amount of blood will be aspirated to confirm placement and 5-10 mL of 1% lidocaine will be infiltrated. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain relief from landmark versus ultrasound guided hematoma block | Pain will be measured using a ten point Likert scale with zero designated as no pain and ten being the worst pain the patient can imagine. The higher score the worse the outcome. | Change in pain score from before the hematoma block to immediately after the reduction/splinting of the forearm fracture | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ultrasound, Hematoma block