Regional anesthesia improves outcome after distal radius fracture fixation over general anesthesia.

Abstract

To compare the efficacy of anesthetic type on clinical outcomes after operative treatment of distal radius fractures. Retrospective review of prospectively collected data. Academic medical center. One hundred eighty-seven patients with a distal radius fracture (OTA type 23) were identified within a registry of 600 patients. Patients with operative distal radius fractures underwent open reduction and internal fixation with a volarly applied plate and screws under regional or general anesthesia. Clinical, radiographic, and patient-based functional outcomes were recorded at routine postoperative intervals. Complications were recorded. One hundred eighty-seven patients met inclusion criteria and had a minimum of 1-year follow-up. There were no differences between the groups with regard to patient demographics or fracture types treated. At both 3 and 6 months post surgery, pain was diminished among those patients who received a regional block. Wrist and finger range of motion for patients who received regional versus general anesthesia was improved at all follow-up points. Patients who received regional anesthesia also had higher functional scores as measured by the Disabilities of the Arm, Shoulder and Hand at 3 months (P = 0.04) and 6 months (P = 0.02). Patients who are candidates should be offered regional anesthesia when undergoing repair of a displaced distal radius fracture. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.