Journal Scan: Foot and Ankle
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Intra-articular block compared with conscious sedation for closed reduction of ankle fracture-dislocations: a prospective randomized trial. White BJ, Walsh M, Egol KA, Tejwani NC. J Bone Joint Surg Am. 2008;90:731–734.
Context: Ankle fracture-dislocations are common injuries whose urgent reduction in the emergency department (ED) often require the administration of analgesia. Conscious sedation often is used successfully but carries a reliance on emergency room staff and the risk of respiratory depression.
Study Design and Results: In a prospective randomized study, 42 patients requiring reduction of an ankle fracture received either an intraarticular hematoma block consisting of 12 cc 1% lidocaine without epinephrine or conscious sedation (combination of narcotics and benzodiazepines determined by an ED physician). Outcomes recorded included metrics of pain during the reduction, pain after the reduction, difficulty of the reduction, and the time elapsed before the reduction was...