TY  - BOOK
AU  - Tageldin, M.E.
AU  - Alrashid, M.
AU  - Gadikoppula, S.
AU  - Atkinson, H.D.
TI  - Periosteal nerve blocks for distal radius and ulna fracture manipulation--the technique and early results
PY  - 2015///
N1  - NMUH Staff Publications; 10
N2  - <h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">BACKGROUND:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">We present a pilot series of patients with distal forearm fractures manipulated following a proximal <span class="highlight">periosteal</span> nerve block with local anaesthesia. This is a novel technique which can be utilised in adults and children and is described herein.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">METHODS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">With a median of 40 years (range 10-81 years), 42 patients (16 children) with distal radial and ulnar fractures were included. Of these patients, 40 underwent <span class="highlight">periosteal</span> blocks in the emergency room or fracture clinic; 2 were already inpatients. Fractures were manipulated routinely and immobilised with plaster. Mobile fluoroscopy was not used for patients in the emergency department or fracture clinic.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">RESULTS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Of the 42 patients, 40 patients (95%) had successful fracture manipulation and did not require subsequent treatment. Two patients (5%) needed subsequent surgery, one for K-wire stabilisation of their fracture and the second for volar plate fixation. The procedure was described as painless in 35 (83%) patients (visual analogue scale/VAS score 0), with 6 (14%) suffering minimal pain (VAS 1-3). In the 12-16-year age group, 15 patients (94%) described the manipulation as painless; 1 patient described the procedure as minimally painful. No additional analgesia of any kind was given. There were no direct complications from any of the <span class="highlight">periosteal</span>nerve blocks.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">CONCLUSIONS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Local anaesthetic <span class="highlight">periosteal</span> nerve blocks injected proximally to the fracture sites are a simple and yet very effective new technique which provide good/excellent analgesia and facilitate the reduction of distal radial and ulnar fractures.</span></p&gt
UR  - https://www.ncbi.nlm.nih.gov/pubmed/26328789
UR  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557923/pdf/13018_2015_Article_277.pdf
ER  -