Closed reduction is a procedure to set (reduce) a broken bone without cutting the skin open. The broken bone is put back in place, which allows it to grow back together in better alignment. It works best when it is done as soon as possible after the bone breaks.

A closed reduction can be done by an orthopedic surgeon (bone doctor), emergency room physician, or a primary care provider who has training and experience doing this procedure.

Fracture reduction - closed

A closed reduction can:

• Reduce tension on the skin and reduce swelling
• Improve the chances that your limb will function normally and you will be able to use it normally when it heals
• Decrease pain
• Help your bone heal quickly and be strong when it heals
• Lower the risk of an infection in the bone
• Allow you to avoid surgery to fix the fracture

Your health care provider will talk with you about the possible risks of a closed reduction. Some are:

• The nerves, blood vessels, and other soft tissues near your bone may be injured.
• A blood clot could form, and it could travel to your lungs or another part of your body.
• You could have an allergic reaction to the pain medicine you receive.
• There may be new fractures that occur with the reduction.
• If the reduction does not work, you may need surgery.

Your risk of any of these problems is greater if you:

• Smoke
• Take steroids (such as cortisone), birth control pills, or other hormones (such as insulin)
• Are older
• Have other health conditions such as diabetes and hypothyroidism

The procedure is often painful. You will receive medicine to block the pain during the procedure. You might receive:

• A local anesthetic or nerve block to numb the area (usually given as a shot)
• A sedative to make you relaxed but not asleep (usually given through an IV, or intravenous line)
• General anesthesia to make you sleep during the procedure

After you receive pain medicine, your provider will set the bone in the right position by pushing or pulling the bone. This is called traction.

After the bone is set:

• You will have an x-ray to make sure the bone is in the right position.
• A cast or splint will be put on your limb to keep the bone in the right position and protect it while it heals.

If you do not have other injuries or problems, you will be able to go home a few hours after the procedure.

Until your provider advises, do not:

• Place rings on your fingers or toes over your injured arm or leg
• Bear weight on the injured leg or arm

Waddell JP, Wardlaw D, Stevenson IM, McMillian TE, et al. Closed fracture management. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 7.

Whittle AP. General principles of fracture treatment. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 53.