What is the purpose of a hematoma block?

Hematoma block (HB), defined as a procedure with local anesthetic injected directly into the fracture site, is a safe and effective alternative technique for pain control in assistance with manual reduction for distal radius fracture [8].

What medication is used in a hematoma block?

Lidocaine and bupivacaine are frequently used in combination to rapidly achieve a long lasting anesthetic state. Fig. 1 illustrates the difference in local anesthetic to published maximum doses. The maximum recommended dose of lidocaine without epinephrine for a hematoma block is 4.5 mg per kg body weight [6,7].

Is a hematoma block the same as a nerve block?

Conclusion: Ulnar nerve blocks provide better analgesia than hematoma blocks for closed reduction of Boxer’s fractures. The two blocks are comparable in terms of patient discomfort during injection, total volume of local anesthetic required, and complication rates.

How do you block a hematoma?


  1. Position extremity on hard surface.
  2. Find landmarks. Fracture site based on imaging.
  3. Draw up anesthetic.
  4. Prep skin.
  5. Enter skin directly over fracture.
  6. Remove needle, apply pressure with gauze.
  7. Dress site, proceed with reduction(s) only after 5-10 minutes when block is fully in effect.

How do you treat a hematoma on the hand?

To manage a hematoma under the skin, nail, or other soft tissue, a person should rest the injured area and apply an ice pack wrapped in a towel to reduce any pain or swelling. It may help to wrap or splint the area around the hematoma to keep the blood vessel from reopening as it heals.

How much lidocaine does it take to block a hematoma?

A lidocaine hematoma block will be injected by an orthopedic surgery resident using 2.5 mg/kg, maximum of 100mg, of 1% buffered lidocaine. The recommended lidocaine dose for hematoma block in children is 3-5 mg/kg.

Does hematoma block hurt?

The disadvantages of the hematoma block include the discomfort and anxiety resulting from injecting into the fracture site, and the potential for a rare complication. Extremity fractures, when displaced or angulated, generally result in the formation of a hematoma between the fracture fragments.

How do I know if my hematoma is infected?

You have signs of skin infection, such as:

  1. Increased pain, swelling, warmth, or redness.
  2. Red streaks leading from the area.
  3. Pus draining from the area.
  4. A fever.

What happens if a hematoma is left untreated?

A hematoma is similar to a bruise or blood clot but, if left untreated, it can damage the tissue and lead to infection. An injury to the nose can rupture blood vessels in and around the septum where there is both bone and cartilage.

What helps a hematoma heal faster?


  • Rest the bruised area, if possible.
  • Ice the bruise with an ice pack wrapped in a towel. Leave it in place for 10 to 20 minutes. Repeat several times a day for a day or two as needed.
  • Compress the bruised area if it is swelling, using an elastic bandage. Don’t make it too tight.
  • Elevate the injured area.

How big is a large hematoma?

Hematomas of the skin may also be named based upon their size. Petechiae are tiny dots of blood usually less than 3 millimeters in diameter (0.12 inch) while purpura are less than 10 millimeters in diameter (0.40 inch) and ecchymosis is greater than 10 millimeters in diameter.

When should I worry about a hematoma?

If the hematoma symptoms are severe or if it continues to expand over the course of a few days, you should visit your doctor right away. Emergency medicine, urgent care, primary care physicians frequently care for patients with hematomas. A primary care doctor can diagnose a soft tissue hematoma in a physical exam.

Should you massage a haematoma?

Most haematomas get better quickly and remember to avoid massage to your injured area. Some may take longer to resolve and you might feel a raised lump for some time. After the first 48 hours and whilst you wait for it to heal, just keep gently exercising and stretching the area as long as you don’t cause pain.

What happens if hematoma goes untreated?