I agree one of the advantages of aspiration is the ability to mobilise early
in stable fractures or no (visible) fracture patients. This in fact may
influence long term mobility more than anything else.
Do people immobilise elbow effusions without evidence of #?
Do people immobilise children with just an effusion seen on X-ray?
SpR in Emergency Medicine
Manchester Royal Infirmary
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Evidence based Emergency Medicine
----- Original Message -----
From: Adrian Fogarty <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, June 27, 2001 9:46 AM
Subject: Re: Radial head fractures
> ----- Original Message -----
> From: "Ray McGlone"
> > Re: Pain relief for radial head fractures
> > It's been my practice for some years now to aspirate an elbow joint if
> > is a large effusion on X ray. I then instil a small amount of marcain
> > and immobilise the joint. I'm not aware of any recent papers on this
> > subject. I heard of an SpR who was intending to study this but didn't
> > out whether the study was completed.
> > Anyone aware of any studies. The technique does provide excellent pain
> > relief for selected patients.
> > Ray McGlone
> > A&E Lancaster
> My practice too, but you can gauge an elbow effusion clinically much
> than you can on x-ray. And why go to the bother of aspirating, only to
> immobilise the joint, and why use marcain? Aspiration of elbow
> achieves rapid pain relief and a dramatic improvement in movement. So I
> can't see the point of then immobilising a joint which you have just "made
> mobile", unless you really have an unstable fracture (in which case
> is often required). And marcain couldn't last for more than a few hours,
> potentially you are filling up that joint space again which may well lead
> increased intra-articular pressure, more pain and restricted movement.
> Adrian Fogarty