Closed reduction

Last revised by Dr Daniel J Bell on 19 Dec 2019

Closed reduction or manipulation is a common non-invasive method of treating mildly displaced fractures. Usually performed in an emergency department or orthopedic clinic with light sedation and analgesia, the fracture is manipulated back into anatomic alignment and immobilized with a cast, brace or splint. Occasionally general anesthetic may be required. 

The basic orthopedic 3-step method of manipulation is usually sufficient to achieve adequate fracture reduction and consists of:

  1. fracture distraction (pull)
  2. increase the deformity (bend)
  3. decrease the deformity (straighten)

Fractures that fail closed reduction often require some form of internal fixation, closed reduction-internal fixation (CRIF) or open reduction-internal fixation (ORIF).

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