{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:46Z","timestamp":1787013766518,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peripheral nerve blocks may provide better conditions for closed reduction of distal radius fractures as compared to other more frequently used modalities. In this systematic review, we evaluate existing evidence on the effect and harm of peripheral nerve blocks for closed reduction of distal radius fractures in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic review with meta\u2010analysis and trial sequential analysis including trials investigating the use of peripheral nerve blocks for closed reduction of distal radius fractures. Co\u2010primary outcomes were (1) the quality of the closed reduction measured as the proportion of participants needing surgery afterwards and (2) pain during closed reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six trials (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009312) met the inclusion criteria. One trial reported on the need for surgery with 4 of 25 participants receiving nerve block compared to 7 of 25 receiving haematoma block needing surgery (RR 0.57, 96.7% CI [0.19; 1.71],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.50). Four trials reported pain during closed reduction. In a meta\u2010analysis, pain was not statistically significantly reduced with a nerve block (\u22122.1 Numeric Rating Scale (NRS) points (0\u201310), 96.7% CI [\u22124.4; 0.2],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.07, tau\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20095.4,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200997%, TSA\u2010adj. 95% CI [\u221211.5; 7.3]). No trial sequential boundaries were crossed, and the required information size was not met. Pre\u2010planned subgroup analysis on trials evaluating ultrasound guided peripheral nerve blocks (patients\u2009=\u2009110) showed a significant decrease in \u2018pain during reduction\u2019 (\u22124.1 NRS, 96.7% CI [\u22125.5; \u22122.6],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01, tau\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.9,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200980%). All trial results were at high risk of bias and the certainty of the evidence was very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The certainty of evidence on the effect of peripheral nerve blocks for closed reduction of distal radius fractures is currently very low. Peripheral nerve blocks performed with ultrasound guidance may potentially reduce pain during closed reduction. High\u2010quality clinical trials are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.14474","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:55:03Z","timestamp":1721696103000},"page":"1149-1160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Peripheral nerve blocks for closed reduction of distal radius fractures\u2014A systematic review with meta\u2010analysis and trial sequential analysis"],"prefix":"10.1111","volume":"68","author":[{"given":"Sanja","family":"Pisljagic","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Copenhagen University Hospital \u2010 North Zealand  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens L.","family":"Temberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Copenhagen University Hospital \u2010 North Zealand  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3225-2516","authenticated-orcid":false,"given":"Mathias T.","family":"Steensb\u00e6k","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Copenhagen University Hospital \u2010 North Zealand  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Yousef","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Copenhagen University Hospital \u2010 North Zealand  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-7295","authenticated-orcid":false,"given":"Mathias","family":"Maagaard","sequence":"additional","affiliation":[{"name":"Centre for Anaesthesiological Research, Department of Anaesthesiology Zealand University Hospital  K\u00f8ge Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana","family":"Chafranska","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Copenhagen University Hospital \u2010 North Zealand  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai H. 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