Authors: Dickman E et al. Am J Emerg Med 2016 Mar.
Pain relief at 2 and 3 hours was similar whether the fracture was intracapsular or extracapsular.
Ultrasound-guided femoral nerve block is increasingly used for analgesia in emergency department patients with hip fracture. Given the anatomy of innervation, a logical question is whether intracapsular fractures might be less amenable to this technique than extracapsular fractures. These investigators conducted a secondary analysis of data from 68 patients aged ≥60 years who received a femoral nerve block for a hip fracture in a prior trial in three academic medical centers.
Fractures were intracapsular in 31 patients and extracapsular in 37. Both groups had significant reductions in pain at 2 and 3 hours. The degree of pain did not differ significantly between the intracapsular and extracapsular groups at 2 hours (mean score on a 6-point scale, 1.61 and 1.35) and at 3 hours (mean score, 1.68 and 1.38).
This study suggests that both intracapsular and extracapsular hip fractures are amenable to ultrasound-guided femoral nerve blockade for pain relief.