Closed reduction of a fractured bone - aftercare
Description
Closed reduction is a procedure to set (reduce) a broken bone without surgery. It allows the bone to grow back together with better alignment. It can be done by an orthopedic surgeon (bone doctor), emergency room physician, or a primary care provider who has training and experience doing this procedure.
After the procedure, your broken limb will be placed in a cast or splint.
Healing can take anywhere from 8 to 12 weeks. How quickly you heal will depend on:
- Your age
- The size of the bone that broke
- The type of break
- Your general health
Alternative Names
Fracture reduction - closed - aftercare; Cast care
Self-care at Home
Rest your limb (arm or leg) as much as possible. When you are resting, raise your limb above the level of your heart. You can prop it up on pillows, a chair, a footstool, or something else.
Do not place rings on your fingers or toes on the same arm and leg until your health care provider tells you it is OK. Swelling can occur and work its way down causing your finger or toes to be bigger.
You may have some pain the first few days after getting a cast. Using an ice pack can help.
Check with your provider about taking over-the-counter medicines for pain such as:
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve, Naprosyn)
- Acetaminophen (such as Tylenol)
Remember to:
- Talk with your provider if you have heart disease, high blood pressure, liver disease, kidney disease, or have had stomach ulcers or bleeding.
- Not give aspirin to children under age 19 years.
- Not take more pain killer than the dosage recommended on the bottle or by your provider.
Your provider may prescribe a stronger medicine if needed.
Activity
Until your provider tells you it is OK, do not:
- Drive
- Play sports
- Do exercises that could injure your limb
If you have been given crutches to help you walk, use them each time you move about. Do not hop on one leg. You can easily lose your balance and fall, causing more serious injury.
Cast Care
General care guidelines for your cast include:
- Keep your cast dry.
- Do not put anything inside your cast.
- Do not put powder or lotion on your skin beneath your cast.
- Do not remove the padding around the edges of your cast or break off part of your cast.
- Do not scratch under your cast.
- If your cast does get wet, use a hair dryer on the cool setting to help it dry. Contact the provider who applied the cast.
- Do not walk on your cast unless your provider tells you it is OK. Many casts are not strong enough to bear weight.
You can use a special sleeve to cover your cast while you shower. Do not take baths, soak in a hot tub, or go swimming until your provider tells you it is OK.
Follow-up
You will likely have a follow-up visit with your provider 5 days to 2 weeks after your closed reduction. It is important for them to check how the fracture is aligned.
Your provider may want you to start physical therapy or do other gentle movements while you heal. This will help keep your injured limb and other limbs from getting too weak or stiff.
When to Call the Doctor
Contact your provider if your cast:
- Feels too tight or too loose
- Makes your skin itch, burn, or hurt in any way
- Cracks or becomes soft
Also contact your provider if you have any signs of infection. Some of these are:
- Fever or chills
- Swelling or redness of your limb
- Foul smell coming from the cast
See your provider right away or go to the emergency room if:
- Your injured limb feels numb or has a "pins and needles" feeling.
- You have pain that does not go away with pain medicine.
- The skin around your cast looks pale, blue, black, or white (particularly fingers or toes).
- It is hard to move the fingers or toes of your injured limb.
Also get care right away if you have:
- Chest pain
- Shortness of breath
- A cough that starts suddenly and may produce blood
References
Waddell JP, Wardlaw D, Stevenson IM, McMillan TE, et al. Closed fracture management. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 7.
Whittle AP. General principles of fracture treatment. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 53.
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
