Overview

Pediatric Fracture Reduction is a procedure used to realign broken bones in children, restoring normal anatomy and function.

Fracture reduction is crucial for proper bone healing, preventing deformity, and restoring function in pediatric patients.

Indications

Displaced Fractures

Bones out of alignment

Angulated Fractures

Bones at wrong angle

Rotated Fractures

Bones twisted

Open Fractures

Bone through skin

Growth Plate Injuries

Salter-Harris fractures

Contraindications

Absolute Contraindications

Patient refusal
Compartment syndrome
Neurovascular compromise

Relative Contraindications

Severe swelling
Multiple trauma
Unstable patient

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient assessment, imaging review, anesthesia planning, and equipment setup.

Step-by-Step Procedure

Step 1: Patient Assessment

Assess fracture, neurovascular status.

⚠️ Common Mistakes to Avoid:

  • Inadequate assessment
  • Missed complications

💡 Pro Tip:

Check pulses and sensation.

Step 2: Imaging Review

Review X-rays and plan reduction.

⚠️ Common Mistakes to Avoid:

  • No imaging
  • Poor planning

💡 Pro Tip:

Understand fracture pattern.

Step 3: Anesthesia

Provide adequate pain control.

⚠️ Common Mistakes to Avoid:

  • Inadequate anesthesia
  • Patient distress

💡 Pro Tip:

Use appropriate anesthesia.

Step 4: Reduction Technique

Perform reduction with proper technique.

⚠️ Common Mistakes to Avoid:

  • Wrong technique
  • Incomplete reduction

💡 Pro Tip:

Use gentle, controlled force.

Step 5: Immobilization

Apply appropriate immobilization.

⚠️ Common Mistakes to Avoid:

  • Poor immobilization
  • Displacement

💡 Pro Tip:

Use proper splinting.

Step 6: Post-reduction Imaging

Confirm reduction with imaging.

⚠️ Common Mistakes to Avoid:

  • No confirmation
  • Poor alignment

💡 Pro Tip:

Verify reduction success.

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Post-procedure Care

Post-procedure care involves immobilization, monitoring, and rehabilitation planning.

Complications & Management

Complication Incidence Signs Management Prevention
Neurovascular injury 1-2% Numbness, pallor Immediate intervention Gentle technique
Compartment syndrome 0.5-1% Pain, swelling Fasciotomy Monitor closely
Incomplete reduction 5-10% Poor alignment Repeat reduction Proper technique
Growth plate injury 1-3% Growth disturbance Long-term follow-up Gentle technique

Clinical Pearls

💡

Use gentle, controlled force.

🎯

Check neurovascular status before and after.

Confirm reduction with imaging.

🔍

Monitor for complications.

📊

Document reduction technique.

🎨

Use appropriate immobilization.

⚠️

Consider growth plate involvement.