Ultrasound-guided supracondylar radial nerve block for closed reduction of a distal radius fracture in the emergency department: Case report

Q4 Medicine

Trauma Case Reports Pub Date : 2024-09-25 DOI:10.1016/j.tcr.2024.101116

Juan José Martínez-Arboleda , Milena Moreno , Juan Pablo Díaz-Solórzano , Alejandro Mejía-Grueso

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引用次数: 0

Abstract

Background

Closed reduction and a closed cast are common treatments for patients with acute distal radius fractures in the emergency room. Many of the common analgesic techniques such as hematoma block may not be effective, which can hinder the stabilization and reduction of fractures.

Case report

An 81-year-old woman who had a Colle's fracture (metaphyseal fracture with dorsal angulation) of the left distal radius arrived at the emergency room. Due to intense pain and need for proper pain management, an ultrasound-guided block of the radial nerve prior to its bifurcation into deep and superficial branches was carried out as an alternative to infiltration of the fracture site. The fracture could be reduced and immobilized with a closed cast as a result of the peripheral nerve block, which caused the patient the least amount of discomfort.

Conclusions

The reduction of a distal radius fracture in the emergency room can be accomplished with safe and efficient analgesia using an ultrasound-guided supracondylar radial nerve block close to the beginning of the deep and superficial branches. This is, as far as we are aware, the first report of an ultrasound-guided supracondylar nerve block utilized to treat a distal radius fracture in our nation.

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超声引导下桡骨髁上神经阻滞用于急诊科桡骨远端骨折闭合复位术：病例报告

背景闭合复位和石膏固定是急诊室治疗急性桡骨远端骨折患者的常见方法。病例报告一位 81 岁的女性患者因左桡骨远端 Colle's 骨折（骨骺骨折伴背侧成角）来到急诊室。由于疼痛剧烈，需要进行适当的止痛治疗，她在超声引导下对桡神经分叉前的深浅分支进行了阻滞，以替代对骨折部位的浸润治疗。结论在急诊室进行桡骨远端骨折的复位手术时，可在超声引导下在桡神经深浅分支起始点附近进行桡神经髁上阻滞，从而实现安全有效的镇痛。据我们所知，这是我国首次报道利用超声引导下桡神经髁上阻滞治疗桡骨远端骨折。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.