التعريف والنظرة العامة
A fracture reduction is an orthopedic procedure used in the treatment of bone fractures and dislocations. Its purpose is to correct problems that affect the alignment of the bones. While the term “reduction” implies a removal or decrease, the etymology of the word itself translates to “returning back to normal”. Thus, the procedure refers to the restoration of the proper alignment of the bones in the event of a displacement or a fracture.
من يجب أن يخضع للنتائج المتوقعة
Fracture reduction is recommended for those whose bones have become displaced or misaligned due to a variety of causes including trauma and sports-related injuries, or as a result of the following bone-related diseases:
- هشاشة العظام, a bone disease caused by calcium deficiency
- Osteomalacia, or the weakening of the bones
- Osteogenesis imperfecta, or brittle bone disease
- Osteosarcoma, a cancer of the bone that affects the shinbone, thigh bone, or the upper arm bone
- Paget’s disease of the bone, a bone disease that disrupts the bone’s ability to repair and renew, causing them to become weak and deformed
- Ewing’s sarcoma, or malignant tumors that forms in or around the bones, usually affecting the long bones of the arms and legs
The risk of suffering a fracture also increases with age, due to the bone’s natural tendency to become weaker and more fragile as a person gets older.
Without proper treatment, fractures may cause chronic pain, disability, or reduced mobility. Fracture reduction is therefore a critical part of the treatment process due to the tendency of affected bones to develop a deformity during the healing process if the fragments are not properly re-aligned.
كيف يتم إجراء العملية؟
Depending on the severity of the condition and other factors, patients with bone fractures can be treated with either or a combination of closed and open fracture reduction procedures.
In a closed reduction, the displaced or fractured bone fragments are manipulated back into their proper position or alignment without surgically exposing them. This, however, has to be done immediately after the fracture occurs. During the procedure, traction is applied at or across the fractured bone to relax the surrounding muscles. This is followed by slowly manipulating the fragments back into place and stabilizing them with a cast or splint. In a modified version of the procedure, the affected body part is supported by a percutaneous wire or K-wire, a percutaneous screw, or an external fixator.
In an open reduction, a surgical incision is made to expose the fragments and put them back in their proper position. Unlike a closed reduction, which can be performed by an experienced and trained physician, only an orthopedic surgeon can perform an open reduction. This procedure is used for cases wherein a closed reduction is not possible. In almost all cases, a closed reduction procedure is usually the first attempt. If it fails to deliver the expected results, an open surgery will be performed.
Additionally, there are also some cases in which the newly reduced position of the fractured bone cannot be successfully held in place by external fixation techniques. Such cases require an open surgery to carry out an internal fixation procedure.
After a fracture has been successfully reduced, the patient undergoes an الأشعة السينية examination, among other tests, to make sure that the fractured bone has been replaced or restored accurately.
المخاطر والمضاعفات المحتملة
Fracture reduction comes with certain risks and complications with pain being one of the biggest concerns. Thus, it is common for doctors to provide patients with numbing medications, such as short-acting anesthetic, mild sedative, or nerve block, prior to the procedure. Another common risk is the possibility of the reduced bone to move out of its place.
Other complications linked with fracture reduction include:
- Pulmonary embolism
- Wound infection
- The need for a revision of either the open reduction or the internal fixation, or both
These complications are more commonly observed in cases wherein the patient also suffers from other health conditions, such as داء السكري, or when the patient is of advanced age.
Despite these risks, the overall rate of complications associated with fracture reduction, including open reduction procedures, is low.
“Closed reduction of a fractured bone.” Medline Plus. 11 June 2008. https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000521.htm
Buckley R. “General Principles of Fracture Care Treatment and Management.” Medscape. http://emedicine.medscape.com/article/1270717-treatment
## What is Fracture Reduction?
**Fracture reduction** is a medical procedure that involves realigning and stabilizing broken bone fragments (fractures) to promote proper healing. It aims to restore bone alignment, reduce pain, and improve function in the affected area.
### Overview of Fracture Reduction
Fractures occur when bones break due to trauma, disease, or underlying conditions. The goal of fracture reduction is to manipulate the bone fragments back into their original position and secure them until they heal. The procedure is typically performed under sedation or general anesthesia to minimize discomfort and ensure patient safety.
There are several types of fracture reduction techniques, including:
* **Closed Reduction:** The bone fragments are manipulated back into place without making any incisions.
* **Open Reduction:** An incision is made to directly visualize and reposition the broken bone fragments.
* **External Fixation:** Metal rods or pins are used to stabilize the bone fragments externally, while internal healing occurs.
### Benefits of Fracture Reduction
* **Promotes Bone Healing:** Fracture reduction aligns the broken bone fragments, creating a favorable environment for bone healing to take place.
* **Reduces Pain:** Realigning the bones helps reduce inflammation and pain associated with the fracture.
* **Improves Function:** Restoring proper bone alignment allows for better movement and function in the affected area.
* **Prevents Complications:** Proper fracture reduction minimizes the risk of complications such as infection, malunion (improper bone healing), and nonunion (failure of bone fragments to fuse together).
### Expected Results of Fracture Reduction
The expected results of fracture reduction vary depending on the severity of the fracture and the individual’s overall health. However, in general, most patients experience:
* **Pain Reduction:** Patients typically experience significant pain relief within a few days after fracture reduction.
* **Improved Mobility:** As the bone heals, patients gradually regain mobility in the affected area.
* **Full Range of Motion:** With proper rehabilitation, patients can usually regain full range of motion in the affected joint.
* **Normal Bone Strength:** The fracture site gradually regains its original strength over time.
Fracture reduction is a crucial medical procedure that restores proper bone alignment and promotes healing in broken bones. By reducing pain, improving function, and preventing complications, fracture reduction helps patients achieve optimal outcomes and regain their quality of life.