In cases of bone fracture, or broken bone in an area of the hand, including the fingers, closed reduction and fixation may be undertaken. This type of surgery realigns the fractured bone and then holds it in position, or immobilizes it, as it heals.
Immobilization can be undertaken with internal fixtures, such as rods, wires, casts, and splints. It is most effective when done as soon as possible after the bone fractures.
Board certified plastic surgeon Dr. Bram Kaufman provides hand surgery to patients in Cleveland, Beachwood, Pepper Pike and Lyndhurst, OH, and surrounding locations.
What are the Advantages of a Closed Reduction?
A closed reduction procedure can:
- Allow the bone to heal faster and be strong after healing
- Pain reduction
- Improve the possibility that the limb will appear normal and the patient will be able to use it normally after it heals
- Reduce the risk of an infection in the bone
- Remove tension on the skin and mitigate inflammation
About the Procedure
The patient will receive medicine to control the pain during the procedure. They might receive:
- A local anesthetic or nerve block to numb the region (typically administered as a shot)
- A sedative to help the patient relax, but not sleep (usually given through an intravenous or IV line)
- General anesthesia to make the patient unconscious during the procedure
After administering the pain medication, the provider will set the bone in the correct position by pulling or pushing the bone. This is known as traction.
Once the bone is set:
- The patient will have an x-ray to ensure that the bone is set in the right position.
- A splint or cast will be put on the limb to help the bone remain in the right position and protect it as it heals.
After the Procedure
In case the patient does not have other injuries or issues, they will be able to go home in a few hours after the procedure.
Patients should not do the following until their provider advises:
- Wear rings on the thumb or fingers over the injured hand
- Bear weight on the injured hand
Potential Risks during a Closed Reduction
The medical care provider will discuss the potential risks of a closed reduction with the patient. Some of these risks are as follows:
- The blood vessels, nerves, and other soft tissues near the bone may be injured.
- A blood clot could develop, and it could travel to the lungs or another area of the body
- The patient may have an allergic response to the pain drug they receive
- New fractures may occur with the reduction
- In case the reduction is ineffective, the patient will require surgery
Use of Implants for Internal Fixation
In a surgical procedure to set a hand fracture, the bone pieces are first repositioned (reduced) into their normal alignment. They are help together with special implants, such as screws, plates, wires, and nails.
Internal fixation allows for relatively short hospital stays. This enables patients to resume function earlier, as well as decrease the incidence of nonunion (improper healing) and malunion (healing in improper position) of fractured bones.
Stainless steel and titanium comprise the implants used for internal fixation, which are resilient and durable. Plastic surgeon Dr. Bram Kaufman receives patients from Cleveland, Beachwood, Pepper Pike and Lyndhurst, OH, and nearby areas for hand surgery.
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