In one study, 80 patients with minimally displaced partial articular radial head fractures treated nonoperatively were randomized to aspiration and injection of bupivacaine with initiation of exercises or exercises alone.1 Aspiration was associated with improved initial comfort and motion, but there was no difference in final motion.

A randomized trial of 40 patients with minimally displaced radial head and neck fractures treated nonoperatively to aspiration alone versus aspiration with intra‐articular injection of bupivacaine. The authors found there was instant relief with aspiration with or without bupivacaine (p <0.001). In both groups on average the Visual Analog Score (VAS) dropped from a VAS of 8 (IQR 7 to 8) in Group A (aspiration only) and 8 (IQR 7 to 9) in Group B (aspiration with bupivacaine injection) to an average of 1.5 and 1, respectively, following intervention. But at all time points thereafter there was no difference in pain with both groups having a VAS of 0 (no pain) at six weeks. ROM (flexion, extension, supination, and pronation) additionally had significant improvement one day after intervention in both groups but had very similar results at six weeks.²

A meta‐analysis concluded that the quality of evidence for aspiration of a traumatic elbow effusion was low and insufficient to recommend it as a routine procedure.³