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.