Fracture Reduction

A fracture is a partial or complete break in a bone. When this occurs, a fracture reduction may be needed to realign, or reduce, the fracture.

Fracture reductions are termed "closed" or "open" depending on the method used. Closed reductions employ hands-on manipulation of the fractured limb to set the bone. The skin remains intact or closed. On the contrary, open reductions are carried out by opening the skin with an incision. The bone is then realigned and the surrounding soft tissues are repaired. Open reduction is necessary in many situations, depending on the type of fracture and the bone in which it occurs.

Why should I have a fracture reduction?
Fracture reductions are essential for proper bone alignment. If you choose not to undergo the procedure, you may be at risk for poor healing, deformity, and reduced function.

What should I do to prepare for these procedures?
If you will be going home the same day of the procedure, plan ahead to have someone drive you home. The medications used during fracture reductions usually take a day or so to wear off.

Talk with your doctor about your recovery time. You may need some help in carrying out your daily activities while you heal. This will allow you to rest and follow your doctor's instructions properly.

What happens during a closed fracture reduction?
You will be given a sedative and anesthesia to relax your body and help you "sleep" through the procedure. The bone will be repositioned back into alignment. If the fracture occurred in an extremity, a cast or splint will be placed on the limb.

In some instances, traction may be used, which involves applying a gentle pull on the bone. Weights or the person's own body weight can be employed to provide the force needed.

What happens during an open fracture reduction?
Again, you will be given medications to help you rest during the process. An incision, or cut, will be made in the skin over the fracture site. The bones are then set into place and secured with hardware, such as rods, plates, pins, or screws. Repairs are made to any damaged soft tissues. The skin is stitched together with sutures or staples.

If the materials used to repair the bone are used only on the inside of the body, the procedure is known as an internal fixation. An external fixation involves hardware that extends outside of the body.

How soon can I go home?
Your length of stay in the medical facility depends on your injury. With closed reductions, you may go home the same day. Open reductions may warrant a few days in the hospital.

What is the treatment after a fracture reduction?
During the healing phase, treatment goals include rest and decreasing pain and inflammation. Nonsteroidal anti-inflammatories medications, such as Advil and ibuprofen, can offer relief. Heat may be applied to the area to promote blood flow. Increased circulation will help speed the healing process. Elevate the area when possible to reduce swelling. Ice massages can be used (after cast removal) 3 to 4 times a day, for 10 to 15 minutes at a time.

Your doctor may also recommend physical therapy. You will be educated in how to move and exercise the affected area. This will help promote healing and prevent joint stiffness.

Are there any complications?
Complications depend on a number of factors such as your age, overall health, extent of the injury, and how well you follow your doctor's instructions. Some problems which may arise include:

  • Malunion (angulated but healed bone)
  • Nonunion (fracture which is not healed)
  • Joint stiffness
  • Loss of feeling due to nerve injury
  • Permanent damage to soft tissues due to impaired blood flow