(Setting a Fracture)

Definition

An open fracture reduction puts pieces of a broken bone into place using surgery. Screws and a plate or external support frame may be needed to hold the pieces in place.

Reasons for Procedure

An open fracture reduction is often done as an emergency procedure when a broken bone is in many pieces. It is done to allow the bones to heal together.

Possible Complications

Problems are rare, but no procedure is free of risk. Some things that may happen are:

  • Reaction to anesthesia
  • Bleeding
  • Infection
  • Nerve damage
  • Fat particles or blood clots that move to the lungs
  • The need for later surgery if the bone does not heal well

Talk to your doctor about things that may raise your risk of problems, such as:

  • Smoking
  • Drinking alcohol
  • Chronic health problems, such as diabetes or obesity
  • The use of certain medicines

What to Expect

Prior to Procedure

This is often as an emergency procedure. Before your surgery:

  • Tell your doctor what you last ate and drank.
  • Tell the doctor about the medicines and supplements you take.

Instructions will be given if the surgery is planned. Before surgery:

  • Arrange for a ride to and from the procedure.
  • Arrange for help at home.
  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.

Anesthesia

Local or general anesthesia may be used. Local anesthesia will numb the area. A sedative may also be given. With general anesthesia, you will be asleep.

Description of the Procedure

An incision will be made in the skin above the break. The pieces of bone will be moved into the right place. 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 outside the body to hold the bones in place. The incision will be closed with stitches and covered with bandages. The area will be protected with a splint or cast.

Open Reduction of Tibia
Tibia repair
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Immediately After Procedure

An x-ray will be done to make sure the bone is in the right place.

How Long Will It Take?

This depends on the type and location of the broken bone.

How Much Will It Hurt?

Anesthesia will prevent pain during the procedure. Pain after the procedure can be managed with medicine.

Average Hospital Stay

Most people are able to go home the same day. People who have problems may need to stay longer.

Post-procedure Care

During your stay, staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding others to do the same
  • Reminding staff to wear gloves or masks
  • Not letting other people touch your incisions
At Home

It can take three to six weeks for a mild fracture to heal. It may take many months for a severe fracture of a long bone to heal. Exercises to help with muscle strength and range of motion will be needed.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • Pain that does not get better with medicine
  • Redness, swelling, more pain, a lot of bleeding, or discharge from the incision site
  • Signs of infection, such as fever and chills
  • Numbness or tingling at the injury site
  • Problems moving the fingers or toes of an injured arm or leg
  • A cast that feels too tight
  • Burning or stinging under a cast
  • Red skin around a cast
  • Itching under a cast that does not go away
  • Cracks or soft spots in a cast
  • Chalky white, blue, or black skin color in the fingers, toes, arm, or leg

If you think you have an emergency, call for medical help right away.

RESOURCES

American Orthopedic Society  http://www.sportsmed.org 

Ortho Info—American Academy of Orthopaedic Surgeons  http://orthoinfo.aaos.org 

CANADIAN RESOURCES

Canadian Orthopaedic Association  http://www.coa-aco.org 

When it Hurts to Move—Canadian Orthopaedic Foundation  http://whenithurtstomove.org 

References

Femoral shaft fracture—emergency management. EBSCO DynaMed website. Available at:  https://www.dynamed.com/management/femoral-shaft-fracture-emergency-management  . Accessed September 24, 2019.

Fractures: an overview. Ortho Info—American Academy of Orthopaedic Surgeons website. Available: http://orthoinfo.aaos.org/topic.cfm?topic=A00139. Updated October 2012. Accessed September 25, 2019.

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 25, 2019.

Welck MJ, Hayes T, et al. Stress fractures of the foot and ankle. Injury 2017 Aug;48(8):1722.

Revision Information