Contributor: Don Stader, MD

Educational Pearls:

• Fractures and dislocations that require reduction do not necessarily require sedation 
• Nerve blocks are an effective alternative that can provide analgesia to reduce fractures and dislocations and provide sustained pain relief after the reduction is completed
• Hematoma blocks are effective for distal radius and various ankle fractures
• Shoulder dislocations can be reduced by performing a scapular nerve block

References

Tezel O, Kaldirim U, Bilgic S, Deniz S, Eyi YE, Ozyurek S, Durusu M, Tezel N. A comparison of suprascapular nerve block and procedural sedation analgesia in shoulder dislocation reduction. Am J Emerg Med. 2014 Jun;32(6):549-52. doi: 10.1016/j.ajem.2014.02.014. Epub 2014 Feb 17. PMID: 24721024.

Tseng PT, Leu TH, Chen YW, Chen YP. Hematoma block or procedural sedation and analgesia, which is the most effective method of anesthesia in reduction of displaced distal radius fracture? J Orthop Surg Res. 2018 Mar 27;13(1):62. doi: 10.1186/s13018-018-0772-7. PMID: 29580286; PMCID: PMC5869786.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD