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Closed reduction or resetting and restoring bone alignment is a procedure in which a trained orthopedic team member will try to restore acceptable bone alignment without an incision or any tools entering the skin (hence the term "closed" because the skin is No penetration).

Closed reduction is always done with sedatives-drugs can cause drowsiness, muscle relaxation, pain reduction and even short-term memory loss, so your child will not remember the process. Due to the need for specially trained emergency department care team members to manage and monitor your child after these medications, closed dose reductions are only performed at our Adele Hall campus and the Kansas Children’s Charity Center. Our two emergency departments have doctors, plastic surgery residents, practicing nurses, and physician assistants who can provide services for these operations around the clock.

If your child needs a closed reduction due to a fracture or joint dislocation (such as a shoulder, elbow, or ankle dislocation), the emergency physician will wait for enough time for the most recent food or drink to be safely emptied before giving an intravenous injection to the stomach. The orthopedic staff will then perform a reduction and use a portable X-ray machine to take X-rays and check the progress and final results.

After the operation is completed, the affected arm or leg will be wrapped in a plaster cast, which helps to maintain the correct position. If the shoulders are reduced, your child will usually be placed in a shoulder strap or shoulder immobilizer. Your care team will discuss instructions for proper care of the cast and pain management. 

Since injuries that require reduction are inherently less stable than injuries that do not require reduction, you will usually be scheduled to follow up in our orthopedic clinic within 1 to 2 weeks. At that appointment, the orthopedist will take X-rays to check the alignment and discuss further treatment with you. Sometimes, closed reduction is not enough to achieve proper alignment and surgery must be performed. However, we always make every effort to readjust your child's fracture without surgery.

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