There are several ways to properly anesthetize a patient who needs a fracture reduction, but the most commonly used method is called a "hematoma block." A hematoma block is performed by administering local anesthesia (Novocain) to the area directly around the fracture.
The first step is to diagnose the injury, and see if it needs to be reset, or "reduced." Usually this is done by obtaining x-rays of the injury, and determining if the fracture is out of place or not.
- Anesthetic Selection:
In almost all situations were a fracture needs to be reduced, some anesthesia will be used. In some situations, the patient may need to be completely asleep for the procedure. However, in some situations a hematoma block, or local anesthesia, may be appropriate.
- Sterilizing the Skin:
If a hematoma block is selected, the skin will be sterilized in with either alcohol, iodine, or both.
- Performing the Hematoma Block:
Once the skin is properly sterilized, the hematoma block can be administered. The local anesthesia is injected from a syringe into the hematoma. The hematoma is the collection of blood around the broken bone. Whenever a bone breaks, bleeding occurs at the site of the fracture. By injecting the local anesthetic into the hematoma, the ends of the broken bone are bathed in the local anesthetic. This provides excellent anesthesia to the area of the fracture.
- Performing the Reduction:
After performing the hematoma block, much of the pain should be alleviated. At that point, the fracture can be reduced. Usually this is performed by manipulating the ends of the broken bone so that they are in a better position. The patient may feel pressure, or feel a crunching sensation, but usually there is not significant pain.
- Applying the Splint:
After reducing the fracture, a splint can be applied to hold the fracture in the proper position.
- Obtaining Post-Reduction X-Rays:
Once the fracture has been reduced (or reset), an x-ray is obtained to ensure that broken bone is now in the proper position.