Closed reduction is a procedure to set a broken bone without surgery. It is often used to treat displaced fractures, which are fractures that are not in the correct position. Closed reduction can be performed by a doctor or an orthopedic surgeon.

The goal of a closed reduction is to align the bones in the correct position so that they can heal properly. The procedure is usually done under local anesthesia, but general anesthesia may be necessary in some cases.

The doctor will first examine the injured area and take X-rays to determine the extent of the fracture. Once the fracture has been assessed, the doctor will begin the closed reduction procedure.

The first step is to apply a splint to the injured area. The splint should be padded to protect the soft tissues and allow for swelling. The doctor will then apply traction to the bone to realign it. Traction is a pulling force that is applied to the bone to help it move into the correct position.

Once the bone has been aligned, the doctor will use a variety of maneuvers to secure it in place. These maneuvers may include:

• Reversing the mechanism of injury: This involves applying the same force to the bone that caused the fracture in the first place. This can help to realign the bone and prevent it from moving out of place again.
• Correcting length, rotation, and angulation: The doctor will use their hands to move the bone until it is in the correct position. This may involve adjusting the length of the bone, rotating it, or changing its angle.
• Immobilizing the joint above and below the injury: This will help to prevent the bone from moving out of place again.
• Applying three-point contact and stabilization: This involves applying pressure to three points on the bone to help hold it in place.

Once the bone has been secured in place, the doctor will apply a cast or splint to the injured area. The cast or splint will help to keep the bone in the correct position while it heals.

Casting is a procedure to immobilize a fractured bone using a rigid material such as fiberglass, plaster, or plastic. Casts are typically applied after a closed reduction has been performed.

The cast is molded to the injured area to ensure that it is snug but not too tight. The cast should be padded to protect the soft tissues and allow for swelling. The cast will need to be worn for several weeks or months, depending on the type of fracture.

Traction is a procedure to apply a pulling force to a fractured bone to help align it and keep it in place. Traction can be used alone or in conjunction with closed reduction and casting.

There are two main types of traction:

• Skeletal traction: This involves inserting pins or wires into the bone near the fracture site. The pins or wires are then attached to weights and pulleys, which apply a pulling force to the bone.
• Skin traction: This involves applying adhesive tape or straps to the skin over the fracture site. The tape or straps are then attached to weights and pulleys, which apply a pulling force to the bone.

Traction can be used for a variety of fractures, including fractures of the leg, arm, and spine. It is often used for fractures that are difficult to reduce with closed reduction alone.

Closed reduction, casting, and traction are all effective treatment methods for fractures. The best treatment method for a particular fracture will depend on the location and severity of the fracture, as well as the patient's individual needs

 

How to Perform a Closed Reduction of a Fracture

A closed reduction is a procedure to set a broken bone without surgery. It is often used to treat displaced fractures, which are fractures that are not in the correct position. Closed reduction can be performed by a doctor or an orthopedic surgeon.

The goal of a closed reduction is to align the bones in the correct position so that they can heal properly. The procedure is usually done under local anesthesia, but general anesthesia may be necessary in some cases.

The doctor will first examine the injured area and take X-rays to determine the extent of the fracture. Once the fracture has been assessed, the doctor will begin the closed reduction procedure.

The first step is to apply a splint to the injured area. The splint should be padded to protect the soft tissues and allow for swelling. The doctor will then apply traction to the bone to realign it. Traction is a pulling force that is applied to the bone to help it move into the correct position.

Once the bone has been aligned, the doctor will use a variety of maneuvers to secure it in place. These maneuvers may include:

• Reversing the mechanism of injury: This involves applying the same force to the bone that caused the fracture in the first place. This can help to realign the bone and prevent it from moving out of place again.
• Correcting length, rotation, and angulation: The doctor will use their hands to move the bone until it is in the correct position. This may involve adjusting the length of the bone, rotating it, or changing its angle.
• Immobilizing the joint above and below the injury: This will help to prevent the bone from moving out of place again.
• Applying three-point contact and stabilization: This involves applying pressure to three points on the bone to help hold it in place.

Once the bone has been secured in place, the doctor will apply a cast or splint to the injured area. The cast or splint will help to keep the bone in the correct position while it heals.

Closed reduction is a safe and effective procedure for treating displaced fractures. It can help to minimize soft tissue trauma and provide patient comfort. If you have a displaced fracture, it is important to see a doctor as soon as possible to have the fracture reduced.

Types of Splints for Fractures

Splints are used to immobilize a fractured bone and prevent it from moving out of place. They can be prefabricated or custom-made, and are typically made from rigid materials such as fiberglass, metal, or plastic.

Here are some of the most common types of splints used for fractures:

• Bulky Jones splint: This is a lower extremity splint that is commonly used for foot and ankle fractures and fractures about the knee. It is made from a posterior slab and a U-shaped slab that is applied from medial to lateral around the malleoli. The splint is padded well proximal and distal to the injury to help with postinjury swelling.

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  Bulky Jones splint for fractures

• Sugar-tong splint: This is an upper extremity splint that is used for distal forearm fractures. It is made from a U-shaped slab that is applied to the volar and dorsal aspects of the forearm, encircling the elbow.

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  Sugar-tong splint for fractures

• Volar splint: This is an upper extremity splint that is used for wrist and hand fractures. It is made from a slab that is applied to the volar (palmar) aspect of the forearm and hand.

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  Volar splint for fractures

• Gutter splint: This is an upper extremity splint that is used for finger and thumb fractures. It is made from a slab that is shaped like a gutter, and is applied to the lateral and medial aspects of the finger or thumb.

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  Gutter splint for fractures

• Air splint: This is a pneumatic splint that is inflated to provide compression and support to a fractured limb. It is a good option for fractures that involve a lot of swelling.

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  Air splint for fractures

When applying a splint, it is important to make sure that it is:

• Rigid enough to immobilize the fracture.
• Padded to protect the soft tissues.
• Secured in place so that it does not move.

It is also important to elevate the injured limb to help reduce swelling. If you are applying a splint to a fracture, it is important to seek medical attention as soon as possible. A doctor or other healthcare provider can assess the injury and make sure that the splint is applied correctly.

Here are some additional tips for choosing and applying a splint:

• Choose a splint that is the correct size for the injured limb.
• Pad the splint well to protect the soft tissues.
• Secure the splint in place with bandages or tape.
• Elevate the injured limb to help reduce swelling.
• Seek medical attention as soon as possible.

By following these tips, you can help to ensure that a splint is applied correctly and effectively.\

How to Cast a Broken Bone

Casting is a common treatment for broken bones. It helps to immobilize the bone and keep it in place while it heals. There are two main types of casts: plaster casts and fiberglass casts.

Plaster casts are made from a material called plaster of Paris. They are easy to mold and are relatively inexpensive. However, they can be heavy and bulky, and they can take a long time to dry.

Fiberglass casts are made from a material called fiberglass. They are stronger and lighter than plaster casts, and they dry more quickly. However, they are more expensive and can be more difficult to mold.

The type of cast that is best for a particular broken bone will depend on the location and severity of the fracture, as well as the patient's individual needs.

Here are the steps on how to cast a broken bone:

1. Prepare the cast materials. Gather the necessary materials, including plaster or fiberglass cast material, padding, and water.
2. Clean the affected area. Wash the affected area with soap and water to remove dirt and debris.
3. Apply padding. Pad the affected area to protect the skin from the cast material. Be sure to pad bony prominences, such as the fibular head, malleoli, patella, condyles, and olecranon.
4. Mold the cast material. If using plaster, soak the cast material in room temperature water for a few minutes until it is soft. Then, mold the cast material around the affected area. If using fiberglass, follow the manufacturer's instructions to mold the cast material.
5. Secure the cast. Once the cast material is dry, secure it with tape or straps.
6. Instruct the patient on cast care. Instruct the patient on how to care for the cast, including how to keep it clean and dry.

Here are some additional tips for casting a broken bone:

• Use cold water to soak plaster cast material. Hot water can cause the cast material to heat up and burn the skin.
• Use a minimum of two layers of padding for bony prominences.
• Make sure the cast is snug but not too tight. A tight cast can cut off circulation to the skin.
• Instruct the patient to elevate the affected limb to help reduce swelling.
• Monitor the cast for any signs of problems, such as redness, swelling, or pain. If any problems are found, contact the doctor immediately.

Casting is a safe and effective treatment for broken bones. By following these steps, you can help to ensure that the cast is applied correctly and that the patient heals properly.

Complications of Casts and Splints

Casts and splints are used to immobilize a broken bone or injured joint. However, they can also cause some complications.

Here are some of the most common complications of casts and splints:

• Loss of reduction: This can happen if the cast or splint is not applied correctly or if the patient moves the injured area too much.
• Pressure necrosis: This is a condition that occurs when the cast or splint is too tight and cuts off circulation to the skin. It can lead to skin breakdown, ulcers, and even gangrene.
• Tight cast or compartment syndrome: This is a serious condition that occurs when the pressure inside the cast or splint is too high. It can cause pain, numbness, and weakness in the affected limb. If not treated, it can lead to permanent damage to the nerves and muscles.
• Thermal injury: This can occur if the cast or splint is made with plaster that is too hot or if the water used to soak the plaster is too hot. It can cause burns to the skin.
• Cuts and burns during cast removal: This can happen if the cast or splint is removed incorrectly. It can also happen if the cast or splint is made with fiberglass, which can be sharp.
• Thrombophlebitis or pulmonary embolism: This is a rare but serious complication that can occur after any type of immobilization. It is more common after lower extremity casts or splints.
• Joint stiffness: This can occur if the cast or splint is worn for too long or if the patient does not move the injured area enough.

Here are some tips to help prevent complications from casts and splints:

• Make sure the cast or splint is applied correctly by a qualified healthcare professional.
• Check the cast or splint regularly for any signs of problems, such as redness, swelling, or pain.
• Move the injured area as much as possible without causing pain.
• Keep the cast or splint clean and dry.
• Follow the instructions of your healthcare provider for cast or splint care.

If you experience any problems with your cast or splint, contact your healthcare provider immediately.

Types of Traction

Traction is a medical procedure that uses a pulling force to align and stabilize bones or joints. It is often used to treat fractures, dislocations, and other injuries.

There are two main types of traction: skin traction and skeletal traction.

• Skin traction uses straps or bandages to apply pressure to the skin. This type of traction is less powerful than skeletal traction, but it is also less invasive.
• Skeletal traction uses pins or wires that are inserted directly into the bone. This type of traction is more powerful and can be used to apply more force to the bone.

The type of traction that is used will depend on the specific injury. For example, skin traction is often used for mild to moderate injuries, while skeletal traction is often used for more serious injuries.

Here are some of the most common types of traction:

• Buck traction: This is a type of skin traction that uses a padded strap to apply pressure to the calf. It is often used to treat ankle and foot injuries.

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  Buck traction

• Russell traction: This is a type of skin traction that uses two padded straps to apply pressure to the calf and thigh. It is often used to treat hip and knee injuries.

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  Russell traction

• Gardner-Wells tongs: This is a type of skeletal traction that uses two screws that are inserted into the skull. It is often used to treat cervical spine injuries.

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  Gardner-Wells tongs

• Halo vest: This is a type of skeletal traction that uses a metal ring that is fitted around the head and four pins that are inserted into the skull. It is often used to treat more serious cervical spine injuries.

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  Halo vest

• Spanning external fixation: This is a type of external fixation that uses pins or wires that are inserted into the bone. It is often used to treat multiple fractures or injuries to the same bone.

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  Spanning external fixation

Traction can be a very effective treatment for fractures and other injuries. However, it is important to note that traction can also have some risks, such as skin breakdown, nerve damage, and compartment syndrome. It is important to monitor the patient closely while they are in traction and to adjust the traction as needed.

Interactive MCQs

1. What is closed reduction used for?

a) To immobilize a fractured bone

b) To apply traction to a fractured bone

c) To set a broken bone without surgery

d) None of the above

Answer: c) To set a broken bone without surgery. Closed reduction is a medical procedure to set a broken bone without surgery, often used for displaced fractures that are not in the correct position.

2. What is the primary goal of closed reduction?

a) To relieve pain in a fractured bone

b) To immobilize a fractured bone

c) To apply a pulling force to a fractured bone

d) To align bones in the correct position for proper healing

Answer: d) To align bones in the correct position for proper healing. The primary goal of closed reduction is to bring the broken bone back to its normal position so that it can heal properly.

3. What is a splint used for?

a) To apply traction to a fractured bone

b) To immobilize a fractured bone

c) To mold a cast around a fracture

d) To remove a cast from a healed fracture

Answer: b) To immobilize a fractured bone. A splint is used to immobilize a fractured bone and prevent it from moving out of place so that it can heal.

4. What are the two main types of traction?

a) Plaster traction and fiberglass traction

b) Skin traction and skeletal traction

c) Buck traction and Russell traction

d) Gardner-Wells tongs traction and halo vest traction

Answer: b) Skin traction and skeletal traction. These are the two main types of traction used to align and stabilize bones or joints.

5. What can be used for fractures that are difficult to reduce with closed reduction alone?

a) Casting

b) Skin traction

c) Skeletal traction

d) A and B

Answer: c) Skeletal traction. Skeletal traction, which uses pins or wires inserted into the bone, is often used for fractures that are difficult to reduce with closed reduction alone.

6. What is casting used for?

a) To immobilize a fractured bone

b) To apply traction to a fractured bone

c) To correct length, rotation, and angulation of a fractured bone

d) To apply pressure to bony prominences

Answer: a) To immobilize a fractured bone. Casting is used to immobilize a fractured bone and support it while it heals.

7. What are some complications of casts and splints?

a) Loss of reduction

b) Joint mobility

c) Skin breakdown

d) All of the above

Answer: d) All of the above. Complications of casts and splints may include loss of reduction, pressure necrosis, tight cast or compartment syndrome, thermal injury, cuts and burns during cast removal, thrombophlebitis or pulmonary embolism, and joint stiffness.

8. What is the difference between skin traction and skeletal traction?

a) Skin traction is less powerful and uses pins or wires, while skeletal traction is more powerful and uses straps or bandages

b) Skin traction is less invasive and uses straps or bandages, while skeletal traction is more invasive and uses pins or wires

c) Skin traction is used for less serious injuries, while skeletal traction is used for more serious injuries

d) Skin traction applies pressure to the skin, while skeletal traction inserts pins or wires directly into the bone

Answer: b) Skin traction is less invasive and uses straps or bandages, while skeletal traction is more invasive and uses pins or wires. Skin traction uses straps or bandages to apply pressure to the skin, while skeletal traction uses pins or wires directly inserted into the bone.

9. What is a common type of splint used for ankle and foot fractures?

a) Volar splint

b) Sugar-tong splint

c) Gutter splint

d) Bulky Jones splint

Answer: d) Bulky Jones splint. A bulky Jones splint is a common type of lower extremity splint used for foot and ankle fractures, as well as fractures about the knee.