{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T08:19:37Z","timestamp":1765009177640,"version":"3.46.0"},"reference-count":34,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Capital Region of Denmark"},{"name":"The Independent Research Fund Denmark"},{"name":"Sygeforsikringen \"danmark\u201d"},{"name":"Copenhagen University Hospital \u2013 North Zealand, Hiller\u00f8d"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,20]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Distal radius fractures account for one-fifth of all fractures in the active elderly population and may cause chronic pain, loss of hand function and reduced work productivity, imposing a significant socioeconomic burden. Most are initially treated with closed reduction and casting, but 30% subsequently require surgery due to insufficient realignment. The current approaches for analgesia for closed reduction are suboptimal. A brachial plexus nerve block provides complete pain relief and muscle relaxation distal to the elbow, potentially creating better conditions for realignment of the fractured bone ends. This may ultimately translate into reduced need for surgery and result in better functional outcomes and fewer complications compared to a haematoma block, which is the current standard care in Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The BLOCK Trial is an investigator-initiated, parallel-group, allocation-concealed, outcome assessor and analyst-blinded, superiority, randomised, controlled, clinical multicentre trial performed at 11 Danish emergency departments. Eligible adult patients with a distal radius fracture who need closed reduction will be included and allocated 1:1 to either an ultrasound-guided brachial plexus nerve block or a haematoma block. The primary outcome is the proportion of patients with distal radius fracture surgery 90 days after closed reduction. We will include 1716 participants to detect or discard a relative risk reduction of surgery of 20%. Secondary outcomes include treatment-related complications, patient-reported wrist function, pain during closed reduction and proportion of patients with unacceptable radiographic fracture position immediately after closed reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and disseminationf<\/jats:title>\n                    <jats:p>\n                      The trial is approved by the Danish Medicines Agency and the Danish Research Ethics Committees (EU CT number: 2024-512191-35-00). All results will be summarised on\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"www.theblocktrial.com\">www.theblocktrial.com<\/jats:ext-link>\n                      , clinicaltrials.gov and euclinicaltrials.eu after publication. Primary and secondary outcome results from 0 to 90 days will be presented in the main article and submitted to a peer-reviewed journal. Results from outcomes on the 12-month follow-up will be presented separately.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06678438\">NCT06678438<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099954","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T16:32:03Z","timestamp":1752510723000},"page":"e099954","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Brachial plexus nerve block versus haematoma block for closed reduction of distal radius fracture in adults: The BLOCK Trial \u2013 a protocol for a multicentre randomised controlled trial"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06678438","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06678438","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Cecilie","family":"Dupont Harwood","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Copenhagen University Hospital\u2014North Zealand, Hiller\u00f8d, Denmark"},{"name":"Collaboration for Evidence-based Practice and Research in Anaesthesia (CEPRA), Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4816-1554","authenticated-orcid":false,"given":"Anne-Sofie Linde","family":"Jellestad","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Copenhagen University Hospital\u2014North Zealand, Hiller\u00f8d, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelien-Xuan Rosendal","family":"Bahuet","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Copenhagen University Hospital\u2014North Zealand, Hiller\u00f8d, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasmus Linnebjerg","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Copenhagen University Hospital\u2014North Zealand, Hiller\u00f8d, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lana Chafranska","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Copenhagen University Hospital\u2014North Zealand, Hiller\u00f8d, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole","family":"Mathiesen","sequence":"additional","affiliation":[{"name":"Collaboration for Evidence-based Practice and Research in Anaesthesia (CEPRA), Copenhagen, Denmark"},{"name":"Department of Anaesthesiology, Zealand University Hospital, K\u00f8ge, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5213-5888","authenticated-orcid":false,"given":"Jonas","family":"Ask\u00f8 Andersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"},{"name":"Department of Orthopaedic Surgery, Copenhagen University Hospital\u2014North Zealand, Hiller\u00f8d, Denmark"},{"name":"Steno Diabetes Center Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janus Christian","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Collaboration for Evidence-based Practice and Research in Anaesthesia (CEPRA), Copenhagen, Denmark"},{"name":"Copenhagen Trial Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"},{"name":"Department 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