Peri-Fracture Injections Reduce Early Postoperative Pain and Opioid Use, Suggests Study
South Korea: Researchers have found in a new study that peri-fracture site injections for distal radius and ankle fractures provided significant pain relief mainly during the early postoperative period and were associated with reduced overall opioid consumption. Further research is needed to determine the optimal injection protocols and whether the approach can provide longer-lasting postoperative analgesia.
The findings come from a meta-analysis of randomized controlled trials published in the Journal of Orthopaedic Surgery and Research by Byung-Ho Yoon from the Department of Orthopaedic Surgery, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, South Korea, and colleagues.
Effective pain management following orthopedic trauma surgery remains a major clinical challenge. Although local surgical site analgesic injections are widely used as part of multimodal pain management in elective orthopedic procedures, their role in fracture surgery involving the distal extremities has remained uncertain. To address this question, the researchers systematically evaluated the available evidence on the effectiveness of peri-fracture-site local analgesic injections after surgery for distal radius and ankle fractures.
The investigators conducted a comprehensive search of PubMed, the Cochrane Library, and EMBASE to identify randomized controlled trials comparing peri-fracture site injections with standard care or control interventions. The primary outcomes included postoperative pain intensity at different time points and total opioid consumption after surgery.
A total of five randomized controlled trials involving 390 participants met the inclusion criteria and were included in the pooled analysis.
Key findings from the meta-analysis include:
- The analysis included five randomized controlled trials comprising 390 patients.
- Patients receiving peri-fracture site injections experienced significantly lower pain scores at 4 hours after surgery compared with the control group.
- No significant differences in pain intensity were observed between the injection and control groups from 8 to 48 hours postoperatively.
- Considerable variability among studies was noted for pain outcomes at 8 and 24 hours after surgery.
- Patients in the injection group had significantly lower overall opioid consumption than those in the control group.
The findings suggest that peri-fracture site injections effectively reduce pain during the immediate postoperative period while lowering opioid requirements. However, the analgesic benefit appears to decline after the first few postoperative hours, limiting sustained pain relief.
The researchers concluded that peri-fracture site injections are a promising option for early postoperative pain control following distal radius and ankle fracture surgery. They called for larger, well-designed studies to identify optimal injection protocols and evaluate strategies to extend the duration of analgesia.
Reference:
Yoon, BH., Kim, M. & Roh, Y.H. Efficacy of perifracture site injections for pain control following distal radius and ankle fracture surgery: a meta-analysis of randomized controlled trials. J Orthop Surg Res (2026). https://doi.org/10.1186/s13018-026-07072-z
Next Story