The Fascia Iliaca Block as the Primary Intraoperative Anesthesia for Hip Fracture Surgery: A Preliminary Study.

Background: Early surgical intervention for hip fractures in the elderly has proven efficacious. However, surgical delays commonly occur in this patient population due to comorbid conditions that put these patients at a high risk for hypotension-related complications of general or neuraxial anesthesia or anticoagulants that delay the safe use of neuraxial anesthesia.

Questions/purposes: The questions/purposes of this study are (1) to investigate if a fascia iliaca block in conjunction with light to moderate sedation could provide adequate analgesia throughout open surgery for intertrochanteric hip fractures (AO/OTA 31-1) without requiring conversion to general anesthesia with airway support and (2) to assess its perioperative complication profile.

Leveraging the plate: reliably restoring volar tilt of distal radius fractures.

Restoration of volar tilt is critical when performing open reduction and internal fixation of distal radius fractures. A reproducible technique is required to consistently achieve this goal. A simple technique using the locking plate and an electrocautery scratch pad as reduction tools can reliably generate volar tilt.

Intraoperative contralateral view for assessing accurate syndesmosis reduction.

Accurate reduction of ankle syndesmosis following injury is essential to minimize tibiofibular diastasis and optimize patient outcomes. Although several radiographic parameters have been described in the coronal plane to assist in reduction, tibiofibular diastasis following syndesmotic injury often occurs in the sagittal plane, with the fibula displacing posterior relative to the tibia. A technique using lateral fluoroscopic assessment of the uninjured contralateral ankle as a comparison and guide for accurate syndesmotic reduction is described.