Nerve blocks before surgery for older adults with lower leg fractures

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This interventional Phase 4 pilot will give pre-incision peripheral nerve blocks as part of anesthetic care for hospitalized patients aged 50 and older who have isolated, radiographically confirmed lower extremity fractures requiring surgical fixation. The approach aims to block afferent pain signals before they trigger systemic stress and inflammatory responses, which may reduce physiologic strain in older adults. Key outcomes include clinical endpoints beyond pain control such as complications, length of stay, opioid requirements, and other perioperative morbidity. The work is conducted at a single center (University of Maryland, Baltimore) and compares outcomes of patients receiving pre-incision blocks with usual perioperative care.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age ≥50 years
2. Isolated fractures
3. Radiographically confirmed lower extremity fracture requiring surgical fixation including:

   1. Femoral shaft
   2. Distal femur
   3. Patella
   4. Proximal tibia
   5. Tibial shaft
   6. Distal Tibia
   7. Pilon fractures
   8. Ankle (malleolar fractures)
   9. Calcaneus
   10. Talus
   11. Hindfoot/midfoot
4. Acute fracture receiving definitive fixation during injury hospitalization

4\) Ability to provide informed consent (patient or legally authorized representative (LAR))

Exclusion Criteria:

1. Contraindication to peripheral nerve block

   1. Infection at planned needle insertion site
   2. Patient refusal
   3. Surgeon or anesthesiologist refusal secondary to the patient's medical status
2. Active peripheral nerve blockade from initial injury analgesic management is defined as:

   a. Risk of local anesthetic systemic toxicity
3. Neurologic or vascular injuries in the affected limb
4. Polytrauma with traumatic brain injury
5. Thoracic injury and/or abdominal injury requiring surgical intervention
6. Current enrollment in a conflicting clinical trial
7. Acute or Subacute residence prior to injury
8. Incarcerated at the time of enrollment
9. Prior enrollment in this trial
10. Unable to obtain informed consent due to language barrier
11. Unable to obtain informed consent because a legally authorized representative was unavailable.
12. Anticipated problems with follow-up compliance

Where it's running

• University of Maryland
  Baltimore, Maryland, United States Recruiting

Study contacts

• Principal investigator: Arissa Torrie, MD, MHS — University of Maryland, Baltimore
• Study coordinator: Arissa Torrie, MD, MHS
• Email: ATorrie@som.umaryland.edu
• Phone: 410 328 2630

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Robotic help for bone break surgeries in orthopaedic trauma

  This trial tests whether using a robotic system to aid reduction and fixation in orthopaedic trauma leads to better accuracy and recovery compared to standard methods.

  Recruiting Prince of Wales Hospital, Shatin, Hong Kong · Hong Kong · NCT07732803

• Mindfulness for fracture recovery and reduced opioid use before and after surgery

  This trial tests whether a brief, guided mindfulness exercise before and after fracture surgery can reduce anxiety and pain and help cut opioid use for adults with fractures.

  Recruiting McMaster University · Hamilton, Ontario · NCT07486505

• Sedation and pain control for adults with fractures and dislocations in the emergency department

  This project will try different sedation and pain-control methods to see which gives adults the best pain relief and satisfaction during emergency-room reductions of fractures or dislocations.

  Recruiting at 3 sites Region Zealand · Holbæk, Region Sjælland and 2 other locations · NCT07314450

• Blood flow restriction–enhanced rehabilitation for people with tibial shaft fractures.

  This trial will test whether using a blood flow restriction device during low-load strengthening exercises helps adults with tibial shaft fractures regain muscle strength and size, heal their fracture, and return to normal function faster than standard exercises alone.

  Recruiting Denver Health and Hospital Authority · Denver, Colorado · NCT06496035

• Using low-dose ketorolac to reduce opioid use in patients with multiple orthopedic injuries

  This study is testing if giving low-dose ketorolac to patients with multiple orthopedic injuries can help manage their pain and reduce the need for long-term opioid use.

  Recruiting at 2 sites Phase 4 Massachusetts General Hospital · Boston, Massachusetts and 1 other locations · NCT06201676

• Emotional therapy for people with ongoing pain after orthopedic injuries

  This study is testing if Emotional Awareness and Expression Therapy can help people with ongoing pain after orthopedic injuries feel better both physically and emotionally.

  Recruiting Johns Hopkins University · Baltimore, Maryland · NCT05989230

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.