When the doctor uses surgery to set a broken bone it is called an open reduction of a fracture. The doctor fixes broken ends of the bone that are not lined up well.

When is it used?

The doctor may suggest performing this procedure if your bone is broken so that it is deformed and needs a pin, screw, or plate attached to it to hold it in a better position.

Alternatives to this procedure include:

• Having a closed reduction and using a cast to try to hold a better position.

• Trying traction and resting in bed for a long time.

• Choosing not to have treatment, while recognizing the risks of your condition: your bone healing in a poor position.

You should ask your doctor about these choices since each one has advantages and disadvantages.

How do I prepare for open reduction of a fracture?

Plan for your care and recovery after the operation. Allow time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your doctor. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water after midnight.

What happens during the procedure?

The doctor will give you a regional or general anesthetic. A regional anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, puts you to sleep, and also prevents you from feeling pain.

The doctor will make a cut over the fracture. The doctor will expose your broken bone and put it into a position where it lines up properly. The doctor may secure your bone with a pin, screw, plate, or wire to help it stay straight. Then he or she will close your cut (incision).

What happens after the procedure?

You may go home later in the day or may need to spend a couple of days in the hospital, depending on how bad the break was, how quickly you recover from the anesthetic, and how much pain you are in. You may need to wear a splint, dressing, or a cast to help keep the bone in place while it heals. You should not stress or move the bone while it is healing unless your doctor tells you to.

Ask your doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

The bone may heal in a better, more normal position. This better position should help you regain more function later. In some cases, the surgery allows a quicker recovery from the fracture than just putting the bone in a cast without surgery.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. In most cases regional anesthesia is considered safer than general anesthesia.

• There is a risk of infection.

• Even with surgery the bone position may not be perfect.

• You may lose some feeling in the area of the break near the incisions.

• If the bone is soft or broken into many pieces, the plate or screws may not hold the bone together completely.

• Because of the surgery and/or if metal pieces are inserted, you may develop blood clots that could cause serious lung problems. In addition, particles of fat from the bone marrow may break loose and get into your bloodstream, enter your lungs, and cause damage.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• The wound is bleeding and/or oozing fluid.

• You develop a fever.

• You become short of breath.

• You are in a lot of pain.

• Your cast is too tight.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.