Haematoma block (HB)
Background
- Direct injection of LA into fracture haematoma
- Similar efficacy and safety with shorter ED LOS than sedation in Colles#
Technique
- 10-15mls of 1% plain Lignocaine injected through the dorsum of the lower forearm into the fracture site (not into the wrist)
- Ensure fresh (haematoma) blood is aspirated
- If the ulnar styloid is also fractured, 3 mls is also injected into this area
- Anaesthesia is complete in about 10 minutes
Beware
- HB is not suitable for fractures with marked displacement
- Supplement this analgesia with Entonox/Penthrox
- Apply a minimum of 2 min. traction to the Colle’s before manipulation
Contents by Dr Íomhar O' Sullivan. Last review Dr ÍOS 20/11/25
