Closed reduction
Formal Definition
A non-surgical procedure to realign a fractured bone or dislocated joint by manipulation from outside the skin, without an open surgical incision; typically performed under conscious sedation, regional anesthesia, or hematoma block in the emergency department or operating room.
How It's Used on the Ward
"We reduced the fracture" or "closed reduction in the ED" — pulling, rotating, and manipulating a displaced fracture or dislocation back into anatomical alignment without surgery.
Example
""Colles' fracture with 40 degrees of dorsal angulation — hematoma block in, conscious sedation on board, and we'll attempt closed reduction and sugar-tong splinting. If we can't hold it, we're calling ortho for ORIF.""
Clinical Context
Closed reduction success depends on fracture pattern, degree of displacement, swelling, time from injury, and patient factors. Requires adequate analgesia and muscle relaxation. Post-reduction X-rays are mandatory to confirm alignment. Acceptable reduction thresholds vary by bone and age group — pediatric fractures tolerate more angulation due to remodeling potential. Failed closed reduction = operative management.
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