IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 1 Ser.5 (January. 2020), PP 01-07 www.iosrjournals.org DOI: 10.9790/0853-1901050107 www.iosrjournals.org 1 | Page Closed Reduction of Displaced Colles’ Fracture Using Hematoma Block Dr.Raja Nag 1 ,Dr. S.N.Chishti 2 , Dr. Kamlesh Kumar Sharma 1 , Dr. Soumendu Nath 1 , Dr.Suraj Kumar 1 . 1. Post Graduate trainee, Orthopaedics Department, RIMS Imphal / Manipur University, India 2. Professor and Head, Orthopaedics Department, RIMS Imphal / Manipur University, India Abstract: Background: One of the most common fractures we encounter in our day to day practice is Colles’ fracture. Closed reduction of these fractures is one of the most important method of management. The objective of the study is to determine the pain lowering effect of hematoma block for closed reduction of these fractures. Materials and Methods: This was a quasi experimental study conducted at department of orthopaedics, RIMS,Imphal from September 2017 to August 2019. All patients with distal radius fracture who attented OPD and casualty were included in this study. Open fractures,intra-articular fractures and comminuted fractures requiring reduction with the use of other forms of anaesthesia were excluded from from the study. Pain score was measured with Visual Analogue Scale at 1 minute, 2 minutes, 3 minutes,4 minutes and 5 minutes after hematoma block. Chi-Square test was used to see the significant difference. Results: Out of 100 patients with Colles’ fractures, males were 44(44%) and females were 56(56%). Highest numbers of patients were of the age group of 51-70 years. Frykmann type 1 fracture was more common (67%) than Frykmann type 2 (33%). Right side was involved in 54 patients (54%) and left side in 46 patients (46%). There was a significant difference in the pain sensation after giving hematoma block with 2% lignocaine solution assessed with VAS Score which ranged from no pain in 52% patients when reduction was performed 5 minutes after giving the block to worst pain in 7% of patients when reduction was carried out 1 minute after giving the block which was statistically significant having p value of 0.000. Conclusion: Hematoma block provides significant pain lowering effect when it is used for reducing displaced Colles’ fracture with excellent clinico-radiographic result making it a procedure of choice in many health care set ups. Key Word: Colles’ fracture; Distal radius; Intra-articular; Hematoma; Lignocaine; Pain measurement; Visual Analouge Scale. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 26-12-2019 Date of Acceptance: 10-01-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Colles’ fracture is the most common fracture treated; more than one sixth of a ll fractures that we treat are Colles’ fracture, that means 10% to 25% of all fractures seen at an emergency department and constitutes 17% of all the fractures and 75% of all forearm fractures. 1 The growth of the elderly population and a rise in the number of active elderly are directly responsible for the increase seen in this age group. 2 In children and adolescent the distal radius fractures are the most common physeal injuries and 46% of physeal injuries occur in distal radius. 3 Management of these fractures has remained a controversial issue. 4 They are often treated with closed reduction and immobilization. Adequate anesthesia is of paramount importance for closed reduction of Colles’ fracture. Literature shows that hematoma block is a safe method to obtain analgesia for closed reduction of fractures and is almost equally beneficious in term of efficacy to intravenous propofol. 5 Now–a-days an increasingly large number of minor procedures are performed under local anaesthesia in clinical settings outside operation theatre. 6 In case of Colles’fracture, there is a marked trend away from general anaesthesia in the favor of local anaesthesia. 7 Hematoma block is a simple form of local anaesthesia which can be performed by Accident and Emergency doctors. It is a technique of injecting local anaesthetic at the site of fracture directly into the hematoma for closed reduction. 8 It is given in the most recent cases of these fractures, not more than 24 hours after the injury. The present study is therefore aimed to show the pain lowering property of the hematoma block for closed reduction of displaced Colles’ fracture in emergency care settings.