Clinical practice for closed reduction of distal radius fractures in Denmark.

Abstract

Introduction: Distal radius fractures (DRFs) are common, with over 14,000 annual cases in Denmark. Most cases are treated non-surgically and may require closed reduction prior to casting. National guidelines for anaesthesia and reduction technique for closed reduction of DRFs are lacking, impacting clinical practices and potentially optimal care. This survey aimed to describe Danish clinical practice for initial treatment and closed reduction of DRFs.

Methods: Between January and April 2025, the survey was distributed online to the 23 physicians responsible for all 44 emergency departments and minor injury units treating DRFs in Denmark. The survey examined the clinical practices used for anaesthesia, reduction technique and post-reduction follow-up for patients with DRFs.

Results: The response rate was 100% (23/23). All departments used haematoma block as anaesthetic method. Manual reduction followed by induced muscle fatigue was reported as the preferred reduction technique (87%, 20/23). Among these, 80% (16/20) mentioned that finger-trap-traction was used as a muscle-fatiguing method. All sites used X-ray imaging to assess the reduction result. Surgery was offered when reduction was unsatisfactory, depending on various criteria, e.g. Clinical Frailty Scale, age or clinical assessment.

Conclusions: In Denmark, haematoma block is the standard anaesthetic method for the closed reduction procedure of DRFs. Mostly finger-trap traction is used to induce muscle relaxation before manual reduction. Clinical practice is generally well-aligned with minor variation in surgical intervention criteria.

Funding: None.

Trial registration: Not relevant.