What is open reduction?

Open reduction is a surgical procedure to repair serious fractures and severely broken bones that cannot be fixed with a splint or cast. It focuses on displaced or unstable fractures or those which involve the joint surfaces.The term “open reduction” means that a surgeon will need to make an incision in the patient’s body to realign and repair the broken bone. It involves the use of hardware such as metal plates, screws, rods and pins to hold the bone together.

Open reduction is an urgent procedure and is recommended if:

• The bone is broken in multiple places
• The bone has moved out of its original position
• The bone is severely broken and is sticking out through the skin
• To repair previously realigned bones that have not healed properly

What happens during open reduction?

During the surgery, the patient is given general or regional anaesthesia . An incision is made above the break and the broken pieces of bone are realigned into the right positions. A metal plate with pins or screws is attached to the bone where it will keep the broken pieces together. This part of the procedure is known as “internal fixation.” The incision is closed with stitches or staples and the area is protected with bandages, cast or splint.

An open reduction surgery can take minutes to several hours and the duration and technique depend on the patient’s case. The surgeon will decide if the plates and screws are to be left in place or removed after healing. After the surgery, the patient will be taught exercises that will help with regaining range of motion and strength. If necessary, they will be instructed on how to use assistive devices like crutches or wheelchair. Each case is unique and recovery time depends on the extent of the injury and the patient’s health.

What is an external fixator?

In specific cases, an external fixator is a preferred technique instead of internal fixation. Here, metal screws or pins are inserted into the bone through small incisions made on the skin and muscle tissue.

A rod or bar is used externally to keep the screws and pins in place and restrict movement of the area. Splints or casts cannot be used as this technique relies on external support. External fixator is recommended in cases where the patient has multiple breaks in the bone but cannot undergo surgery immediately,incase of extensive skin toes or damage or along with vascular injuries.