ICJR Interviews: Managing Pain after ORIF for Tibial Plateau Fractures

    Patients undergoing total knee arthroplasty often receive a continuous femoral nerve block to control pain after the procedure, with generally good results.

    Could that extend to patients who undergo open reduction internal fixation for a tibial plateau fracture?

    Unfortunately, the answer is no, according to a study from Boston University that compared standard care (intravenous patient-controlled analgesia pump) with the use of a continuous femoral nerve block with bupivacaine plus standard care in 42 patients.

    Margaret Cooke, MD, said she and her colleagues found no difference between groups in VAS pain scores at 4, 8, 12, 24, 36, 48, or 72 hours postoperatively or in opioid consumption.

    But there may be a silver lining: Patients with bicondylar fractures had higher pain scores and used more opioids than patients with unicondylar fractures. Dr. Cooke said further research may show that continuous femoral nerve blocks will benefit the latter group.

    Click the image above to hear Dr. Cooke discuss the study, “Femoral Nerve Catheters After Open Reduction Internal Fixation of Tibial Plateau Fractures: A Randomized Trial” (Poster 531), which was presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando.

    Producer and Director: Michael Bugera; Post Production: Charles J. Maynard