Isolated Distal Radius Fracture Reductions in Adult Emergency Department Patients in a Large Healthcare System

Area of Science:

• Orthopedic Surgery
• Emergency Medicine
• Pain Management

Background:

• Distal radius fractures are common in older adults, frequently requiring reduction and analgesia in the emergency department (ED).
• Management strategies vary across community and academic EDs.

Purpose of the Study:

• To summarize real-world management of distal radius fracture reductions in EDs.
• To compare the effectiveness of different analgesia modalities.

Main Methods:

• Retrospective analysis of adult distal radius fracture visits across 21 EDs.
• Categorization of reductions by hematoma block, procedural sedation, or ultrasound-guided nerve block (UGNB).
• Comparison of patient demographics, pain scores, opioid administration, ED length of stay, and return rates.

Main Results:

• Hematoma block was the most common reduction method (75.1%).
• Procedural sedation and UGNB showed the greatest pain reduction.
• UGNB was associated with the longest ED length of stay.
• No significant difference in 30-day return rates across methods.

Conclusions:

• Hematoma blocks are the predominant method for distal radius fracture reduction.
• Procedural sedation and UGNB offer superior pain relief compared to hematoma blocks.
• UGNB is less common but effective, predominantly used in community EDs.