title: Ultrasound-guided hematoma block for distal radial and ulnar fractures.
abstract: BACKGROUND
  Hematoma blocks of the radius can provide excellent analgesia for simple distal radius fractures. However, the landmark-based approach can be difficult, and ultrasound guidance may improve success of the block and analgesia during reduction. There is limited literature describing the ultrasound-guided approach, and prior case descriptions have not involved comminuted fractures or concomitant ulnar styloid fractures.
  
  
  OBJECTIVE
  This report reviews the technique of the ultrasound-guided hematoma block for distal radius fractures and introduces a second step, which can be used in the case of concomitant distal ulna fractures.
  
  
  CONCLUSIONS
  The use of the ultrasound-guided hematoma block allows for direct visualization of needle advancement, as well as a simple approach to anesthetizing most distal radial and ulnar fractures.
  
  
  CONCLUSIONS
  The ultrasound-guided hematoma block may be helpful in improving anesthesia of complicated distal radial and ulnar fractures, especially when landmark-based localization is difficult.
authors.affiliation: Department of Emergency Medicine, Cook County Hospital, Chicago, Illinois.
authors.forename: Michael
authors.initials: M
authors.lastname: Gottlieb
authors.affiliation: Department of Emergency Medicine, Cook County Hospital, Chicago, Illinois.
authors.forename: Karen
authors.initials: K
authors.lastname: Cosby
mesh_terms: D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D006406:Hematoma; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D011885:Radius Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014458:Ulna Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: hematoma; hematoma block; radius fractures; ulna fractures; ultrasonography