Background and Aims Hip fractures pose challenges in patient management, especially when surgical risks outweigh benefits. Inadequate analgesia from conservative treatment options prompted the development of new procedures targeting hip capsule denervation. We aimed to evaluate the efficacy of chemical neurolysis as a conservative treatment for hip fractures, within our department’s protocol.
Methods Patients who were deemed inoperable by either the orthopedists or anesthesiologist were evaluated for eligibility criteria and informed consent was obtained. A diagnostic block was performed under ultrasound guidance using 5 mL of 2% lidocaine in the pericapsular nerve group plane. With the needle in situ, the block’s efficacy was evaluated by performing flexion, internal and external rotation of the hip joint. If the block was deemed positive, the needle’s location was confirmed, and 6 mL of 99% alcohol was administered. Prior to needle removal, 1 mL of local anesthetic was flushed through the needle.
Results During the one-year period from May 2022 to May 2023, a total of five patients (aged 55 to 96) underwent the procedure. All were previously unable to ambulate. At the 1-day follow-up, one patient experienced pain, which resolved by the 5-day evaluation. None of the patients reported pain at the 5-day follow-up, and all were discharged pain-free. There were no reported adverse effects. Follow-up was scheduled in outpatient orthopedic consultations.
Conclusions Chemical neurolysis seems to provide effective and safe conservative treatment for hip fractures, offering reliable analgesia for non-surgical candidates. Effective collaboration between orthopedic and anesthesiology teams was vital for high-quality patient care.
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