Closed Reduction of a Fracture
Your child has a fracture (break) in a bone. Due to the alignment of the bone after it broke the Orthopedic Team (bone specialists) were consulted to place the bone(s) in a better position so it can heal straight. This procedure is called a closed reduction of the fracture (“setting the bone”). A cast or splint is then put on to help the bone heal in place.
Before the Procedure
Your child will receive medicines from the Emergency Department to help with pain before the procedure starts. Some children will receive medicine that will make them sleepy (they will forget the procedure); this is called a “procedural sedation” and will be discussed with you by the Emergency Department team if it is right for your child.
Preparation for the Procedure
After the right medicines have been given to your child, the orthopedic team member will set the bone in the injured body part and use a small x-ray machine to make sure the bone(s) is in the right position. Once the bone is in the right position a cast or splint is placed on the injured limb (arm or leg).
Sometimes the bone cannot be set. In that case, surgery may be required to fix the bone. If this is necessary, it will be discussed with you.
After the Procedure
Most often your child can go home after the bone is set. Some children may need to stay overnight for observation to make sure their swelling is not so severe that it could cause damage while the limb is in the cast.
If your child had an “open fracture” (this occurs when the bone pokes through the skin) he or she will need to stay in the hospital to get antibiotics through an IV to prevent infection.
Sometimes additional tests, such as another x-ray or CAT scan, may be necessary after the bone is set to make sure surgery will not be necessary to hold the bone in place.
What To Do at Home
Most often, a child needs a cast for about 6 weeks to allow correct healing of a fracture. Sometimes, the child can have the cast changed to either a shorter cast or a waterproof cast. This depends on the location and healing of the fracture as well as your child’s orthopedic specialist’s preference. Your child’s orthopedic provider will discuss this with you in clinic at follow-up.
Please see Helping Hand HH-II-60, Circulation Checks and Helping Hand HH-II-2, Cast or Splint Care for further information about care at home. Do not allow your child to bathe or shower before you read the instructions in HH-II-2 for detailed information.
Activity and Diet
- Your child should not take part in these activities until cleared to do so by his or her orthopedic provider: gym, recess, or any high-impact activities (running, jumping, contact sports and climbing).
- Weight must not be put on the injured limb. Your child should use crutches or a walker as instructed.
- Your child may eat his usual foods.
When to Call the Doctor
Call the Orthopedic Clinic at 614-722-5175, or return to the Emergency Room if:
- The cast seems too tight
- Your child cannot wiggle his or her fingers
- Your child has new complaints of numbness
- The pain cannot be controlled with medicine prescribed or recommended for your child
- Your child has any side effects that continue or are very bothersome.
Please call the Orthopedic Clinic at 614-722-5175 on the next business day after the procedure, between 8am and 4pm, to schedule your child’s first follow-up appointment.
You can expect to have regular follow-up appointments with the Orthopedic Clinic. Write down all your questions as you think of them. Bring this list with you when you see the orthopedic specialist. Be sure to call the Orthopedic Clinic at 614-722-5175 if you cannot keep the appointment.
Your child will need to be seen in the Orthopedic Clinic in the next 5 to 10 days. He or she will have x-rays to make sure the bone(s) continues to be in a good position. Sometimes over the first week or two, the bones may move or shift. X-rays will show the position of the bones. Most likely, your child will need to be seen in the Orthopedic Clinic at least 4 times in the next 6 weeks.
If you need help to get to the clinic please ask to speak with the Emergency Department Social Worker or call 614-722-6300. You can also talk to your child’s provider at the first follow-up appointment. Here are more ways to get help:
- Bus passes or cab vouchers: NCH can give families bus passes or cab vouchers when necessary. There are some restrictions. Call Social Work at 614-722-6300 with questions
- Transportation options from insurance companies: some local insurance companies including Caresource, UHC, Molina, and Medicaid will provide transportation to medical appointments. You must call your insurance company to schedule this. They request at least 48 hours’ notice before the appointment in order to set up transportation.
- Orthopedic Clinic provides excuse letters for work and the patient’s school
- The Orthopedic clinic allows another adult (family member or friend you choose) to bring your child in for follow-up appointments. Ask for Helping Hand HH-36, Designation of Another Person to Consent for Treatment, if interested.
If you have any questions, be sure to ask your child’s doctor or nurse.
Nationwide Children’s Orthopedics Locations
Phone number to schedule for all locations: 614-722-5175
479 Parsons Ave.
Columbus, Ohio 43215
5680 Venture Dr.
Dublin, Ohio 43017
- East Broad
6435 East Broad St.
Columbus, OH 43213
- New Albany
150 West Main St.
New Albany, OH 43054
584 County Line Rd. West
Westerville, Ohio 43082
*Days at each location are variable depending upon provider schedules, and are subject to change.
Closed Reduction of a Fracture (PDF)
HH-II-232 5/17 Copyright 2017, Nationwide Children’s Hospital