Reduction (orthopedic surgery)

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Reduction (orthopedic surgery) is a medical procedure in orthopedic surgery that involves the correction of bone fractures or dislocations. The primary goal of reduction is to restore the normal alignment of the bone or joint, thereby facilitating proper healing and restoration of function. Reduction can be categorized into two main types: closed reduction and open reduction.

Closed Reduction

Closed reduction refers to the manipulation of the bone without making an incision into the skin. It is often the first line of treatment for many fractures and dislocations. During this procedure, the orthopedic surgeon applies force to the affected area to realign the bones into their proper position. This method is less invasive than open reduction and carries a lower risk of infection. However, it may not be suitable for all types of fractures or dislocations.

Open Reduction

Open reduction involves surgically exposing the bone to directly visualize and fix the fracture or dislocation. This method is typically used when closed reduction is unsuccessful or when the injury is too complex to be treated with closed reduction alone. During open reduction, various orthopedic hardware such as screws, plates, and rods may be used to stabilize the bone. Open reduction is more invasive than closed reduction and carries a higher risk of complications, such as infection and nerve damage.

Reduction Techniques

The specific technique used for reduction depends on the type and severity of the fracture or dislocation, as well as the patient's overall health. Techniques may include manual manipulation, traction, and the use of specialized tools. In some cases, anesthesia or sedation may be administered to reduce pain and facilitate the procedure.

Aftercare

After a reduction procedure, immobilization of the affected area is often necessary to ensure proper healing. This may involve the use of casts, splints, or braces. The duration of immobilization varies depending on the injury and the patient's healing process. Physical therapy may also be recommended to restore strength and mobility.

Complications

While reduction is generally safe, complications can occur. These may include infection, nerve damage, blood vessel damage, and complications related to the use of anesthesia. There is also a risk that the bones may not heal properly, leading to malunion or nonunion.

Conclusion

Reduction is a critical procedure in the management of fractures and dislocations. The choice between closed and open reduction depends on the specifics of the injury and the patient's condition. With proper technique and aftercare, reduction can effectively restore function and promote healing of the affected area.

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Contributors: Prab R. Tumpati, MD