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Fracture Reduction -- Closed

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Fracture Reduction—Closed

(Setting a Fracture)

Definition

This procedure is done to return a broken bone to its proper alignment. A closed fracture reduction involves setting the bone without cutting into the skin.
Broken Bones in the Arm
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Reasons for Procedure

Fracture reduction is done for the following reasons:
  • So that the bone can heal properly and more quickly
  • To decrease pain and prevent later deformity
  • To regain use of the bone and limb

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a fracture reduction, your doctor will review a list of possible complications, which may include:
  • Nerve damage
  • Fat particles from the bone marrow or blood clots from veins that can dislodge and travel to the lungs
  • Need for surgery if the bone does not heal properly
  • Reaction to anesthesia
Factors that may increase the risk of complications include:
  • Advanced age
  • An open fracture (broken bone is sticking out of skin)
  • Pre-existing medical condition
  • Diabetes
  • Use of steroid medicine
  • Smoking
Be sure to discuss these risks with your doctor before the procedure.

What to Expect

Prior to Procedure

Your doctor will likely do the following:
  • Physical exam
  • X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones
  • Provide a splint for the broken bone to decrease the risk of additional injury
Leading up to the procedure:
  • You may be given antibiotics if you have an open fracture.
  • Arrange for a ride to and from the procedure. Also, arrange for help at home.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.

Anesthesia

Your doctor will usually give you local anesthesia to numb the area; it is given as an injection. You may also be given a sedative.
In some cases, general anesthesia will be used. You will be asleep during the procedure if this is the case.

Description of the Procedure

The bone fragments will be manipulated into their normal position. The doctor will apply traction and use a cast or splint to hold the bones in place. No incisions are needed.

Immediately After Procedure

The doctor will order another x-ray to ensure the bone is in the correct position.

How Long Will It Take?

This depends on the type and location of the fracture.

How Much Will It Hurt?

You will have some pain after the procedure. Ask your doctor about medicine to help with the pain.

Average Hospital Stay

You will usually be able to go home after the procedure.

Post-procedure Care

At Home
When you return home, do the following to help ensure a smooth recovery:
  • Rest your injured arm or leg on pillows. Elevate it above the level of your heart.
  • Gently move uninjured joints and toes.
  • Keep the cast, splint, and dressing clean and dry.
  • Wait until a "walking cast" is dry before walking on it.
  • Do not pull out the cast's padding. Do not break off any part of the cast.
  • Keep objects, dirt, and powder out of the cast.
  • Do not try to scratch under the cast.
  • Do not drive until told it is safe.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Be sure to follow your doctor’s instructions.
Small bones usually heal in 3-6 weeks. Long bones will take more time. Your doctor may have you work with a physical therapist. He can help you to regain normal function. In some cases, you may be able to return to daily activities within a few days while wearing the cast or splint.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:
  • Severe or unusual pain that is not relieved by pain medicine
  • Signs of infection, including fever and chills
  • Cough, shortness of breath, or chest pain
  • Numbness and/or tingling in the injured extremity
  • Loss of movement in the fingers or toes of the injured arm or leg
  • The cast feels too tight
  • Burning or stinging sensations under the cast
  • Redness of the skin around the cast
  • Persistent itching under the cast
  • Cracks or soft spots develop in the cast
  • Chalky white, blue, or black discoloration of fingers, toes, arm, or leg
In case of an emergency, call for medical help right away.

RESOURCES

American Academy of Orthopaedic Surgeons http://www.aaos.org/

American Orthopedic Society http://www.sportsmed.org/tabs/Index.aspx/

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org/

Canadian Orthopaedic Foundation http://www.canorth.org/

References

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/ . Accessed September 2, 2009.

Setting a broken bone without surgery (closed reduction). University of Michigan Health System website. Available at: http://www.med.umich.edu/1libr/aha/aha%5Fclored%5Fcrs.htm . Updated January 2008. Accessed September 2, 2009.

¹10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Gosselin RA, Roberts I, Gillespie WJ. Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev . 2009;(4):CD003764.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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