# Comparison of Intra-articular Haematoma Block and Procedural Sedation for the Manipulation of Closed Ankle Fracture Dislocations: A Cross-Sectional Study

## TL;DR

This study compares two methods for reducing ankle fractures and finds that a local injection is as effective and cheaper than sedation.

## Contribution

Demonstrates that intra-articular haematoma block is a viable, cost-effective alternative to procedural sedation for ankle fracture reduction.

## Key findings

- No significant differences in pain scores between the two methods.
- IAHB had lower costs and faster treatment times compared to procedural sedation.

## Abstract

Background

Ankle fracture dislocations are commonly reduced in the emergency setting under procedural sedation (PS), which requires trained clinicians and monitoring. This study aimed to evaluate the patient-reported efficacy of intra-articular haematoma block (IAHB) as an analgesic alternative to PS for the closed reduction of ankle fracture dislocations.

Methods

Data from patients with displaced ankle fractures requiring manipulation between October 2020 and April 2021 were analysed. Patients who received IAHB were compared to those who received PS. IAHB involved the injection of 10 mL of 1% lignocaine into the joint space.

Results

Twenty-eight patients received PS, and 25 received IAHB. There were no statistically significant differences in visual analogue scale (VAS) scores before, during, or after treatment (p > 0.05). First-attempt reductions were successful in 76% of IAHB patients compared to 82.1% of PS patients. IAHB was associated with lower medication costs and a shorter time to manipulation.

Conclusion

IAHB is a cost-effective and safe alternative to PS for managing ankle fracture dislocations.