Regional anesthesia improves outcome after distal radius fracture fixation over general anesthesia.

OBJECTIVE: To compare the efficacy of anesthetic type on clinical outcomes after operative treatment of distal radius fractures.

DESIGN: Retrospective review of prospectively collected data.

SETTING: Academic medical center.

PATIENTS: One hundred eighty-seven patients with a distal radius fracture (OTA type 23) were identified within a registry of 600 patients.

INTERVENTION: Patients with operative distal radius fractures underwent open reduction and internal fixation with a volarly applied plate and screws under regional or general anesthesia.

MAIN OUTCOME MEASUREMENTS: Clinical, radiographic, and patient-based functional outcomes were recorded at routine postoperative intervals. Complications were recorded.

RESULTS: One hundred eighty-seven patients met inclusion criteria and had a minimum of 1-year follow-up. There were no differences between the groups with regard to patient demographics or fracture types treated. At both 3 and 6 months post surgery, pain was diminished among those patients who received a regional block. Wrist and finger range of motion for patients who received regional versus general anesthesia was improved at all follow-up points. Patients who received regional anesthesia also had higher functional scores as measured by the Disabilities of the Arm, Shoulder and Hand at 3 months (P = 0.04) and 6 months (P = 0.02).

CONCLUSION: Patients who are candidates should be offered regional anesthesia when undergoing repair of a displaced distal radius fracture.

LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.