Reduction is a surgical procedure to restore a fracture or dislocation to the correct alignment. This sense of the term “reduction” does not imply any sort of removal or quantitative decrease but rather implies a restoration. When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their normal anatomical position. Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement.
Reduction could be by “closed” or “open” methods.
- Open reduction is where the fracture fragments are exposed surgically by dissecting the tissues.
- Closed reduction is the manipulation of the bone fragments without surgical exposure of the fragments.
Because the process of reduction can briefly be intensely painful, it is commonly done under a short-acting anaesthetic, sedative, or nerve block. Once the fragments are reduced, the reduction is maintained by application of casts, traction or held by plates, screws, or other implants which may in turn be external or internal. It is very important to verify the accuracy of reduction by clinical tests and X-ray, especially in the case with joint dislocations.
An orthopedic cast, or simply cast, is a shell, frequently made from plaster or fiberglass, encasing a limb (or, in some cases, large portions of the body) to stabilize and hold anatomical structures, most often a broken bone (or bones), in place until healing is confirmed. It is similar in function to a splint.
The setting of unmodified plaster starts about 10 minutes after mixing and is complete in about 45 minutes; however, the cast is not fully dry for 72 hours.
Nowadays bandages of synthetic materials are often used, often knitted fiberglass bandages impregnated with polyurethane, sometimes bandages of thermoplastic. These are lighter and dry much faster than plaster bandages. However, plaster can be more easily moulded to make a snug and therefore more comfortable fit. In addition, plaster is much smoother and does not snag clothing or abrade the skin.
Orthopedic surgery or orthopedics, also spelled orthopaedic[s], is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.