Table of Contents
Mechanism of action of Hematoma Block
- Local anesthetic (LA) is injected directly into the fracture hematoma, spreading the contents to the fracture site and the immediate local environment.
- This LA targets the nerve fibers (especially small unmyelinated) in the periosteum and surrounding tissues.
Indications of Anteromedial Portal Injection
- Aspiration: Septic arthritis, Gout
- Aspiration and hematoma block: Reduction of ankle fractures
- Medial malleolus
- Medial axilla of tibial plafond
- Tibialis anterior tendon
- Supine position
- Aseptic precautions
- Mark the landmarks
- Insert the needle at tibiotalar joint line between medial malleolus and tibialis anterior tendon
- Aspirate hematoma
- Inject 1% lidocaine without epinephrine in pre-determined dose