In contrast to closed reduction, open reduction of a fracture
|A||Produces a shorter healing time|
|B||Decreases trauma to the fracture site|
|C||Produces a higher incidence of nonunion|
|D||Reduces the risk of infection|
|E||Requires longer Periods of immobilization|
Produces a higher incidence of nonunion
a. Open reduction of a fracture involves the restoration of normal bone alignment under direct observation at surgery. In effect, open reduction converts a simple fracture into a compound (or open) fracture and thereby increases the risk of infection.
b. Operative manipulation also increases trauma at the fracture site and may consequently add to the probability of infection. Hematomas at the site of fracture may be important for early healing; open reduction, which usually involves removing the clots in the field, could contribute to a delay in bone healing and to nonunion.
c. The major advantage of open reduction is the shorter period of immobilization it allows, an advantage that often outweighs all the disadvantages previously mentioned, as in the open reduction of femoral neck fractures in the elderly. This allows these patients to get out of bed much sooner than if they were treated with several weeks of traction.