Distal Radius Fx (Dr. Rao)
Hematoma Block
Can be used alone or in combination with other analgesic modalities such as IV narcotics or benzodiazepines
Hematoma blocks result in similar analgesia as conscious sedation with IV Propofol AND leads to shorter ED stay times
10cc 1% Lidocaine
Identify the fracture site by palpating along the dorsal aspect of the forearm to feel for bony step-off.
Cleanse this entire area thoroughly with skin cleanser. Insert needle attached to syringe filled with 10cc 1% Lidocaine at that site and advance needle along periosteum until needle falls into fracture site.
Draw back on plunger to aspirate blood confirming the needle is in the fracture site. Inject 10cc Lidocaine into fracture site and remove needle. Allow 10-15min to pass to ensure full analgesic effect.
Finger Trap
Involves passive traction with finger traps and weights applied to upper arm to provide counter traction. The patient sits in this position for 10-15 minutes and is then splinted while still in the finger traps.
Manual Manipulation
Classically called the Jones Method. Involves hyperextension of the wrist to recreate the mechanism of injury followed by volar translation of the distal radial fragment. This is done while an assistant is providing counter-traction at the upper arm with the elbow flexed to 90 degrees. The reduction should be splinted with the hand held in ulnar deviation.
Sugartong Splint
