B ackground: An alternative to general anesthesia was tested against hematoma block by a double-blind, randomized clinical trial in reduction of Colles fracture. Method: 96 patients more than 18 years old with displaced fractures of distal radius were selected from 2007-2009 on the basis of: 1) informed consent; 2) no contraindication to any method of analgesia; 3) no associated injury. Patients were randomized into 2 equal groups. The A group received Propofol intravenously, whereas the B group received 10 ml of 2% Lidocaine Hydrochloride into the fracture hematoma. Fractures are reduced under acceptable criteria. Pain measured by Visual Analogue Scale (VAS) was recorded before, during, and after reduction. Time to Emergency department, to manipulation and to hospital discharge is measured. In radiographic before, after reduction and a week later the radial tilt, ulnar migration and dorsal tilt are measured. Loss of these parameters were study statistically data analysis by KW statistics. Results: 96 patients with displaced fractures of distal radius at mean age 54.3 (19-84) years old, M/F rate 37/59, left/right hand 37/58., from 2005-2008. VAS during reduction was 0 in group A and 0.97 ± 0.7 in group B and VAS after reduction was 2.72 ± 0.7 in group A and 2.25 ± 0.2 in group B. Time to reduction was 2.63 ± 0.96 hr in A and 0.90 ± 0.47 hr in B After a week, 21 fractures lose reduction in group A and 22 in group B. Conclusion: Hematoma block by local anesthetic is a safe and effective alternative to intravenous general anesthesia in reduction of Colles fracture.

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Background: Although fractures of the distal radius are a common clinical presentation, many factors affect instability of these injuries. The aim of this study was to assess the influence of age, sex, distal radial ulnar joint injury (DRUJ), ulnar styloid fracture, and dorsal displacement in late collapse of distal radius fractures. Methods: Three hundred twenty-nine patient fractures were measured for dorsal tilt, radial inclination and ulnar variance after reduction and 2 months later. Reduction loss was analysed statistically against variables like DRUJ involvement, ulnar styloid fractures, age, sex, and AO classification. Results: After two months there was loss of reduction in 171(51.9%) cases. Loss of reduction was related to age, AO classification, involvement of DRUJ, ulnar styloid fractures and initial displacement. Conclusions: Factors such as age, associated DRUJ injury, ulnar styloid fracture are predictive of loss of reduction. Knowing these predictor factors, can aid in decision regarding treatment methods.

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