3-5) Of those that are displaced, most undergo acute closed reduction and immobilization; however, unacceptably high rates of re-displacement have been reported, ranging anywhere from 21% to 47%.
The goal of a closed reduction is to achieve and maintain an acceptable reduction with minimal residual deformity.
Patients were randomized to closed reduction
and casting or external fixation.
2-3,5-9) Simmen reported that the failure rate seen with closed reduction
techniques is significant, and he advocated open methods in the belief that they produce better results.
Apergis and colleagues (13) performed a study where 20 patients were treated by open reduction internal fixation (ORIF) and eight patients by closed reduction
An audible "clunk" is a sign of a successful closed reduction
Twenty-nine patients with either supination external rotation 4 (SE4) or pronation external rotation 3 and 4 (PE3, PE4) fractures were treated with isolated medial malleolar fixation and closed reduction
of the lateral malleolus.
The success rate of closed reduction
of THA dislocation has been shown to be between 94% and 97%.
After successful closed reduction
and completion of the stability examination, the patient should undergo a CT scan to assess for any acetabular femoral head pathology and to evaluate possible loose bodies within the hip joints.
Acetabular development after closed reduction
of developmental dislocation of the hip.
Six of these patients sustained significant dislocations which required formal closed reduction
A large sleeve of periosteum was found within the fracture site, preventing closed reduction
The incidence of avascular necrosis after closed reduction
ranges from 3% to 14% in three-part fractures and up to 34% in four-part fractures.
Four papers dealt with external fixation versus closed reduction
and cast treatment and one paper looked at open reduction internal fixation with or without additional external fixation.
Duwelius PF, Connolly JF: Closed reduction
of tibial plateau fractures.