A closed reduction is a method healthcare professionals use to set a broken bone without making an incision. This is a less invasive alternative to surgery that can reduce recovery time.

Other benefits of closed reduction include avoidance of general anesthesia, a lower risk of infection, and less pain.

Doctors usually recommend closed reduction for mildly displaced fractures — those in which the ends of the broken bone have stayed close together. They may also use this method if open reduction surgery is not an option.

This article explores the closed reduction of a fracture and what to expect.

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A closed reduction is a nonsurgical procedure to treat mildly displaced fractures. In this procedure, healthcare professionals use gentle manipulation to set the broken bones back into place without cutting into the skin.

Doctors typically perform the procedure in an emergency department or an orthopedic clinic.

First, a person receives light sedation and analgesia. Sometimes they may receive a general anesthetic. Then, a healthcare professional gently moves the bones back into anatomic alignment and immobilizes them with a cast, brace, or splint.

Closed reduction is often as successful as surgical treatment with internal fixing plates. However, fractures that do not heal with closed reduction often require some form of internal fixation.

A closed reduction for a fracture involves several steps:

  1. Fracture distraction (pull): The healthcare professional pulls the fractured bones away from each other until they are out of alignment.
  2. Disengagement (rotate): They rotate the fracture in the opposite direction to mimic the deformity.
  3. Reapposition (realign): They apply gentle pressure to the sides of the fracture to realign the bones.
  4. Release: Once they have placed the bones back into position, they immobilize the fracture with a cast, brace, or splint.

The following sections outline what to expect before, during, and after a closed reduction.

Before the procedure

The person will receive pain medications and possibly light sedation.

During the procedure

A person can expect to feel some discomfort and pressure as the healthcare professional aligns the broken bones. After the medications take effect, the healthcare professional will set the broken bone.

They will then use a small X-ray machine to ensure that the bone or bones are in the correct position. Once they confirm the position, they will immobilize the fracture with a cast or splint.

After the procedure

Often, an individual can go home after the bone is set. However, some people may need to stay overnight for observation to ensure that there is no excessive swelling.

A person may wear a cast for around 6 weeks to allow the bone time to heal — but depending on the severity and complexity of the fracture, some may need to wear a cast longer.

During this time, the person may need to attend follow-up appointments to monitor the fracture and ensure that it is healing correctly. They should try to keep the cast clean and dry and should not attempt to remove it themselves. A healthcare professional will advise on how to best care for the cast and when to return for cast removal.

Typically, closed reduction fracture techniques involve less pain and fewer complications than surgical options. Still, closed reduction carries some risks:

  • The surrounding nerves, blood vessels, and soft tissues may become damaged.
  • The bone may not heal properly as a result of improper alignment.
  • Blood clots can form and cause serious complications.
  • The procedure may cause new fractures.

One of the most common complications after the procedure is redisplacement, in which the bones shift out of their proper position. This occurs in 21–46% of people. If it does occur, a person will need a repeat closed reduction or surgical intervention.

Closed reduction carries several benefits, as it:

  • is a less invasive option than surgery
  • usually does not require general anesthetic
  • has a shorter recovery time than surgery
  • reduces the risk of infection and other complications related to open reduction procedures
  • can lead to an improved range of motion
  • results in less pain
  • removes tension on the skin and reduces swelling

People should carefully follow their doctor’s instructions for closed reduction fracture healing. If they experience any of the following, they should contact their doctor:

  • persistent or worsening pain
  • new swelling or redness in the area
  • tingling or numbness in the area
  • inability to move the affected body part
  • skin discoloration near the fracture site
  • fever, chills, or nausea

Closed reduction is a nonsurgical procedure to treat broken bones. It involves gently realigning the fractured bones and then immobilizing them with a cast, brace, or splint. This option usually carries fewer risks than surgery and can lead to improved mobility and reduced pain.

Although closed reduction fractures typically heal without significant complications, people should contact their doctor if they have persistent pain or new symptoms.