Efficacy and Safety of Hematoma Block Versus Brachial Plexus Block for Closed Reduction of Extra-Articular Distal Radius Fracture: A Prospective Study

May 31, 2026 updated by: Rohit Shrestha, Kathmandu University School of Medical Sciences

EFFICACY AND SAFETY OF HEMATOMA BLOCK VERSUS BRACHIAL PLEXUS BLOCK FOR CLOSED REDUCTION OF EXTRA-ARTICULAR DISTAL RADIUS FRACTURE: A PROSPECTIVE STUDY

Distal radius fractures are one of the most common types of fractures, affecting mostly youngsters and the elderly. Safety, ease of use, affordability, and effectiveness all play a role in analgesia during reduction. This study's goal is to assess how well the Hematoma Block (HB) reduces distal forearm fractures in a developing nation like Nepal. At a tertiary care hospital, a randomized comparative study is used. The individuals with distal forearm fractures that have been radiologically confirmed are enrolled after taking informed consent. When reducing distal forearm fractures, the patients are divided into two groups: Brachial Plexus Block (BPB group) and Hematoma Block group. We note the level of pain before, during, and after reduction using the Visual Analogue Scale (VAS) in both groups. The patient's radiological correction is assessed by Modified Sarmiento Criteria with an immediate post reduction radiograph.

Comparing Hematoma Block and Brachial Plexus Block, we can choose a definitive easy method for reduction that is easy, safe and less time consuming. Hence, the study will provide a guide for commonly occurring distal radius fracture.

Hypotheses of the Study:

Null hypothesis (Ho): There is no difference between feasibility, safety and quality of reduction in the two groups of anesthesia techniques.

Ho: Safety, efficacy and quality of reduction with Hematoma block = Brachial plexus block

Alternate hypothesis (H1): There is a difference between feasibility, safety and quality of reduction in the two groups of anesthesia techniques.

H1: Safety, efficacy and quality of reduction with Hematoma block ≠ Brachial plexus block

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Nepal
    • Bagmati
      • Dhulikhel, Bagmati, Nepal, 45200
        • Dhulikhel Hospital, Kathmandu University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion criteria:

  1. Adult male or female patients in the age range of skeletally mature (18 years and above)
  2. Displaced distal radius fracture, requiring manipulation
  3. Only extra-articular fractures.

Exclusion Criteria:

  1. Open fractures (Gustilo Anderson open fracture Type I, II and III), intra-articular fractures, and comminuted fractures.
  2. Undisplaced distal radial fractures which do not require manipulation.
  3. Patients who have a history of an adverse reaction to local anesthetics.
  4. Polytrauma, multiple injuries

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Brachial Plexus Block
Ultrasound-guided regional anesthesia administered by anesthesiology personnel
Procedure: Brachial Plexus Block
Ultrasound-guided regional anesthesia administered by anesthesiology personnel
Active Comparator: Hematoma Block
Local anesthetic infiltration into the fracture hematoma by an orthopedic surgeon/resident.
Procedure: Hematoma Block
Local anesthetic infiltration into the fracture hematoma by an orthopedic surgeon/resident.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Severity Assessed by Visual Analogue Scale (VAS)
Time Frame: 1 year
Pain severity during fracture reduction will be assessed using the Visual Analogue Scale (VAS), a 10-point scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates worst imaginable pain. Pain scores will be recorded prior to, during, and immediately following fracture reduction. Higher scores indicate worse pain severity.
1 year
Quality of Fracture Reduction Assessed by Plain Radiographic Parameters
Time Frame: 1 year
Quality of reduction following fracture manipulation will be assessed using plain radiographs in posteroanterior (PA) and lateral views. Radiographic parameters include ulnar variance (mm), radial length (mm), radial tilt (degrees), and dorsal/palmar tilt (degrees). Measurements will be compared between hematoma block and brachial plexus block groups.
1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Procedure-Related Complications
Time Frame: 1 year
Complications related to fracture reduction or anesthesia technique will be recorded during hospital stay and follow-up. Complications may include neurovascular injury, compartment syndrome, local anesthetic-related adverse events, infection, or failure of reduction. Outcome will be reported as number and percentage of participants experiencing complications.
1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kathmandu University School of Medical Sciences

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 20, 2024

Primary Completion (Actual)

April 1, 2026

Study Completion (Actual)

April 2, 2026

Study Registration Dates

First Submitted

May 24, 2026

First Submitted That Met QC Criteria

May 31, 2026

First Posted (Actual)

June 4, 2026

Study Record Updates

Last Update Posted (Actual)

June 4, 2026

Last Update Submitted That Met QC Criteria

May 31, 2026

Last Verified

January 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 43/51

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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