Closed Fracture Reduction

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<Index>

 

Definition

-  External manipulation of fracture to restore normal anatomy

 

Rationale

-  Mx of fracture providing

-  Return of normal anatomy (alignment, length, rotation)

-  Promotes normal healing

-  Less soft tissue complications: swelling, neurovascular compromise

-  Reduction of pain

-  Should be attempted even in fracture requiring internal fxation

 

Procedure

-  Adequate analgesia: Morphine

-  Apply axial traction to bony segments in line of limb

-  Disimpaction of most fractures

-  +/- return of normal limb length

-  +/- reduction of deformity

-  Increase in angulation may be required to reduce

-  May cause a., v., n. damage

-  If limb angulated apply force in direction opposite to mechaninsm of injury

-  Success indicated by

-  Limb alignment

-  Palpation of bone

-  Absence of telescoping

-  X-ray

-  Ensure no redisplacement: immobilisation

-  Plaster fixation

-  Skin or skeletal traction

-  Thomas splint

-  Cast bracing

-  External fixation