BackgroundDistal radius fractures are among common fractures in the elderly. Regarding the age, background diseases, and possible risks, analgesia method is of great importance in this group.ObjectivesThe aim of this study was to compare two analgesia methods including hematoma block and general anesthesia in people over 60 years in the orthopedic emergency department.Methods68 elderly patients referring to the emergency department of a medical teaching center were selected based on the inclusion criteria for a non-randomized clinical trial. The patients were placed in two groups of 34, which were matched for age and sex. Hematoma block was used as the analgesic method in one group and general anesthesia was used in the other group. These two groups were compared for pain intensity, analgesia duration, and anesthesia side effects. The SPSS software (Statistical Package for the Social Sciences, version 17.0, SPSS Inc., Chicago, Ill, USA) was used for data analysis.Results68 elderly patients (mean age of 70.3 ± 6.6) with a dislocated distal radius fracture which required closed reduction were examined. The duration of manipulation and surgery and discharging time were significantly different between two groups and they were all lower in the hematoma blocked group. Pain intensity evaluation indicated a statistically significant difference during initial hours after fracture reduction and fixation so that pain intensity was less in elderly patients under hematoma block than patients who underwent general anesthesia in one and six hours after surgery. Need for narcotic was 35.2% in the general anesthesia group which also showed a significant between-group difference.ConclusionsHematoma block analgesia used in distal radius fractures of the elderly is a very safe and effective method that seems preferable to general anesthesia in emergency departments.

Introduction: There are various methods of training for medical students in different colleges. Fast knowledge transfer and maximum learning are the main goals of education. Due to the limited time and also high volume of content knowledge during residency, using the best methods of training can play an important role in enhancing the skills of residents. In the current study, small group discussion as a teaching method was compared with the traditional method. Methods: In this cohort study, two groups of residents that had finished a 4-year course of orthopedic residency training programs in Tabriz and Urmia universities of medical sciences was being examined. They were divided in two groups. In order to compare the impact of the training on residents, it was compared with the result of the State Board standardized exam. The number of residents passing the written test and the Objective Structural Clinical Examination (OSCE) per year have been identified and compared with the groups under investigation. Results: Fifty-one residents, including 4 women (7.8%) and 47 men (92.2%), were studied for this purpose. Success rate for the small group discussion in the written exam was 59.2% and in the OSCE was 24% (95% CI). On the other hand, the success rates for the group who were trained in the traditional way were 37% and 16.6% in the written exam and OSCE, respectively. In both cases the differences were significant. Conclusion: The small group discussion method is an effective method in residency training in surgical fields that increases medical students' learning abilities compared to traditional methods of education.

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