Aspiration alone versus aspiration and bupivacaine injection in the treatment of undisplaced radial head fractures: a prospective randomized study.
OBJECTIVE
Some physicians advocate that aspiration of elbow joint hematoma in radial head fractures is helpful not only for determining a mechanical block to motion from a fracture fragment but also for improving the elbow motion and pain. However, the supplementary role of intra-articular anaesthetic injection is unclear.


METHODS
In this prospective randomized study, 40 patients with undisplaced radial head fractures (Mason I) were treated with elbow joint aspiration alone (20 patients) or aspiration plus intra-articular injection of 3 mL of bupivacaine 0.5% (20 patients). Active elbow exercises were immediately commenced. The patients were evaluated at 1 day, 1, 3, and 6 weeks, 3 and 6 months, and 1 year.


RESULTS
No difference was found in terms of range of motion, pain and elbow function between the 2 groups in all the examined time points. The improvement in the above parameters achieved a plateau at 3 weeks in both groups.


CONCLUSIONS
Intra-articular use of local anaesthetic after joint aspiration does not offer any benefit over aspiration alone in the treatment of undisplaced radial head fractures and its routine application is not supported by the clinical data.
Chalidis
Byron E
BE
Department of Orthopedics, Hippokration General Hospital, Thessaloniki, Greece. byronchalidis@gmail.com
Papadopoulos
Pericles P
PP
Sachinis
Nick C
NC
Dimitriou
Christos G
CG
D000293:Adolescent; D000328:Adult; D000368:Aged; D002045:Bupivacaine / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D007270:Injections, Intra-Articular; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011336:Probability; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000628:therapy*; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012016:Reference Values; D055815:Young Adult; D000092464:Elbow Injuries
D002045:Bupivacaine