Fracture Reduction -- Open

Definition

This procedure is done to return a broken bone to its proper alignment. An open fracture reduction involves cutting through the skin to realign the bones during an operation. Screws and a plate or external support frame may be needed to hold the fragments in place.

Reasons for Procedure

This procedure is used if the bone is in many pieces, is difficult to reduce, or wasn't reduced with a closed reduction.

Fracture reduction is done for the following reasons:

  • So that the bone can heal properly and more quickly
  • To decrease pain and prevent later deformity
  • To 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
  • Infection
  • Bleeding
  • Fat particles from the bone marrow or blood clots from veins that may break loose and travel to the lungs
  • Need for additional surgery if the bone does not heal properly
  • Reaction to anesthesia

Factors that may increase the risk of complications include:

  • Increased age
  • Preexisting medical condition
  • An open fracture—broken bone is sticking out of skin
  • Diabetes
  • Use of steroid medication
  • Smoking
  • Obesity

What to Expect

Prior to Procedure

Your doctor will likely do the following:

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

Leading up to the procedure:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
  • You may need to take antibiotics, if advised by your doctor.
  • If you are 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.

Anesthesia

Your doctor may give you:

  • General anesthesia —blocks pain and keeps you asleep through the surgery
  • Local anesthesia—numbs the area; given as an injection (You may also be given a sedative.)

Description of the Procedure

A incision will be made in the skin covering the break. This is to expose the bone fragments. The bone fragments will be moved into their normal position. Screws, a plate with screws, or a rod may be used inside the body or an external frame fixed to the bone fragments may be used to hold the bones in place. The incision will be closed with stitches. The area will be protected with a splint or cast and dressings.

Open Reduction of Tibia
Tibia repair
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Immediately After Procedure

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

How Long Will It Take?

This depends on the type and location of the fracture.

How Much Will It Hurt?

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

Average Hospital Stay

0-3 days (depending on the severity of the injury and your recovery)

Post-procedure Care

At Home

Small bones usually heal in 3-6 weeks. Long bones will take more time. Your doctor may have you work with a physical therapist. Therapy can help you to regain normal function.

Be sure to follow your doctor’s instructions.

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
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • 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 the fingers, toes, arm, or leg

In case of an emergency, call for emergency medical services right away.

Revision Information

  • American Academy of Orthopaedic Surgeons

    http://orthoinfo.aaos.org

  • American Orthopedic Society

    http://www.sportsmed.org

  • Canadian Orthopaedic Association

    http://www.coa-aco.org

  • Canadian Orthopaedic Foundation

    http://www.canorth.org

  • 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 September 26, 2014.

  • 10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Gosselin RA, Roberts I, Gillespie WJ. Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev. 2009;(4):CD003764.