Fracture reduction is a medical procedure to reposition bones after a fracture, putting them in the correct place and holding them with casts, braces, or splints so the bones can heal properly. In a closed reduction, a doctor can manipulate the bones from the outside without the need to make an incision, while open fracture reductions require surgery to expose the bone and put it back in place. After reduction, the patient may spend weeks or months in a cast, depending on the type of fracture and how well the patient heals. This procedure is necessary to prevent complications like infections, permanent loss of mobility in the limb, and chronic pain.
When a patient presents with a fracture, a doctor will order some x-rays to visualize the bone and determine the best course of action. If a fracture is simple and did not break the skin, the doctor can apply traction externally to release the muscles and pull the bones back into place. The patient usually receives sedation and a muscle relaxant for comfort, and in some cases it may be necessary to place the patient under general anesthesia. The doctor takes another x-ray to confirm that the bones are properly aligned, and then casts the fracture to hold it in place.
With an open fracture reduction, the patient needs surgery. It may be necessary to treat a complex fracture or in cases where the bone breaks through the skin. In the operating room, an orthopedic surgeon will carefully clean the wound and reposition the bones. It may be necessary to pin them together for added stability. Then the surgeon closes the wound and applies a cast to fix the injury in position while the bones heal.
After a fracture reduction, the patient should experience some immediate pain relief because the bones are no longer displaced. The doctor will want to follow up on the patient to make sure the bones are knitting together well. Once the bone heals, it is possible to remove the cast and allow the patient to start physical therapy to rebuild muscle strength. Some atrophy of the muscles around the fracture is common, and the patient's bone may also erode slightly, making it important to receive good nutrition during healing to keep the bones healthy and strong.
Potential complications of a fracture reduction can include infection, damage to nerves and blood vessels, or an improperly set fracture, resulting in pain and disability for the patient. It is also possible to dislodge clots of fat or blood around the fracture site, causing blockages in the blood vessels and exposing patients to the risk of stroke, pulmonary embolism, or myocardial infarction. The risks of not setting a fracture are much more dangerous and outweigh the potential costs of a fracture reduction.