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J Accid Emerg Med. 1995 September; 12(3): 187–188.
PMCID: PMC1342476

A tide of change in the management of an old fracture?


Colles' fractures are manipulated under a variety of anaesthetic techniques. An increasing awareness of cost and time within the National Health Service contributes to a marked change in the anaesthetic management of Colles' fractures. This paper presents the results of a survey of the anaesthetic techniques used in the larger accident and emergency (A&E) departments of the UK, and demonstrates the increasing popularity of the haematoma block compared with 5 years ago (7% in 1989 vs. 33% in 1994), at the expense of the general anesthetic (44% in 1989 vs 24% in 1994). The popularity of the Bier's block has remained unchanged (33% in 1989 and 1994). Local and regional anaesthetic techniques can be safely performed by A&E doctors, with appropriate monitoring, and this has beneficial resource implications for the anaesthetic department and the hospital.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Hunter JB, Scott MJ, Harries SA. Methods of anaesthesia used for reduction of Colles' fractures. BMJ. 1989 Nov 25;299(6711):1316–1317. [PMC free article] [PubMed]
  • Wardrope J, Flowers M, Wilson DH. Comparison of local anaesthetic techniques in the reduction of Colles' fracture. Arch Emerg Med. 1985 Jun;2(2):67–72. [PMC free article] [PubMed]
  • Bartholomew K, Sloan JP. Prilocaine for Bier's block: how safe is safe? Arch Emerg Med. 1990 Sep;7(3):189–195. [PMC free article] [PubMed]
  • Brown EM, McGriff JT, Malinowski RW. Intravenous regional anaesthesia (Bier block): review of 20 years' experience. Can J Anaesth. 1989 May;36(3 Pt 1):307–310. [PubMed]
  • Quinton DN. Local anaesthetic toxicity of haematoma blocks in manipulation of Colles' fractures. Injury. 1988 Jul;19(4):239–240. [PubMed]

Articles from Journal of Accident & Emergency Medicine are provided here courtesy of BMJ Publishing Group