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Fracture Reduction—Closed

(Setting a Fracture)

En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

A closed fracture reduction is resetting a broken bone without cutting into the skin.

Broken Bones in the Arm

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Reasons for Procedure

A closed reduction is done to realign pieces of a broken bone. It is done to:

  • Allow the bond to heal properly and more quickly
  • Decrease pain and prevent later deformity
  • 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 or blood clots dislodging and traveling to the lungs
  • Need for surgery if the bone does not heal properly
  • Reaction to anesthesia

The closed reduction may not be successful. Surgery may be needed to properly align the bones.

Factors that may increase the risk of complications include:

  • Increased age
  • An open fracture (broken bone is sticking out of skin)
  • Pre-existing medical condition
  • Diabetes
  • Use of steroid medications
  • Smoking

Be sure to discuss these risks with your doctor before the procedure.

What to Expect

Your doctor may do the following:

  • Physical exam
  • X-ray —to look for the broken bone
  • Provide a splint for the broken bone to decrease the risk of additional injury until the fracture can be reduced

Leading up to the procedure:

  • You may be given antibiotics if you have an open fracture.
  • If you at home 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.

Your doctor will usually give you local anesthesia to numb the area. 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.

The bone fragments will be moved into their normal position. Traction will be applied and a cast or splint will be used to hold the bones in place. No incisions are needed.

Another x-ray will be ordered to make sure the bone is in the correct position.

This depends on the type and location of the fracture.

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

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

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 you are told it is okay.
  • 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. A physical therapist 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 medication
  • 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 for Sports Medicine

http://www.sportsmed.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association

http://www.coa-aco.org

Canadian Orthopaedic Foundation

http://www.canorth.org

References:

Broken bones. Nemours' KidsHealth.org website. Available at: http://kidshealth.org/parent/general/aches/b_bone.html. Updated October 2012. Accessed August 26, 2013.

Setting broken bones. Cedars-Sinai website. Available at: http://www.cedars-sinai.edu/Patients/Programs-and-Services/Orthopaedic-Center/Treatment/Setting-Broken-Bones.aspx. Accessed August 26, 2013.

10/30/2009 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.

Last reviewed September 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.