Name of the Procedure:

Closed Treatment of Radial Shaft Fracture; with Manipulation
Common Name(s): Closed Reduction of Radial Shaft Fracture

Summary

Closed treatment of a radial shaft fracture with manipulation is a non-surgical procedure to realign and stabilize a broken radial bone in the forearm. It involves using manual pressure to reposition the bone fragments without making any incisions.

Purpose

This procedure addresses fractures of the radial shaft, a common type of forearm fracture. The goals are to correctly align the bone fragments, facilitate proper healing, and restore normal function to the forearm.

Indications

• Visible deformity or swelling in the forearm
• Inability to move the wrist or elbow
• Severe pain in the forearm
• Diagnosis of a radial shaft fracture through X-rays

Preparation

• The patient may be asked to fast if sedation is planned.
• Adjustments to medications, such as blood thinners, might be necessary.
• Pre-procedure X-rays or scans to assess the fracture.

Procedure Description

1. Anesthesia/Sedation: The patient may receive local anesthesia or conscious sedation for comfort.
2. Manipulation: The healthcare provider uses their hands to apply controlled pressure, manipulating the bone fragments back into place.
3. Imaging: X-rays or fluoroscopy may be used to guide the manipulation and verify correct alignment.
4. Casting/Splinting: The arm is immobilized with a cast or splint to maintain the proper position during healing.

Duration

The procedure typically takes 30 minutes to 1 hour.

Setting

The procedure is usually performed in an outpatient clinic, emergency room, or surgical center.

Personnel

• Orthopedic surgeon or emergency room physician
• Nurses
• Radiologic technologist (if imaging is used)
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Pain or discomfort during manipulation
• Swelling and bruising
• Improper alignment or malunion
• Nerve or blood vessel injury
• Risk of a compartment syndrome
• Infection (rare)

Benefits

• Non-surgical realignment of the bone
• Reduced healing time compared to surgical methods
• Restoration of normal forearm function
• Immediate pain relief after proper alignment

Recovery

• Keep the arm elevated to reduce swelling.
• Regular follow-up appointments for X-rays to monitor healing.
• Avoid heavy lifting or strenuous activity for several weeks.
• Physical therapy may be recommended to restore strength and mobility.

Alternatives

• Surgical intervention (open reduction and internal fixation)
  • More invasive but may be necessary if closed treatment is unsuccessful.
  • Involves placing hardware (plates, screws) to stabilize the bone.
  • Pros: More stable fixation, faster return to full activity.
  • Cons: Surgical risks, longer recovery time.

Patient Experience

Patients might feel pressure and discomfort during bone manipulation. After the procedure, pain should be controlled with prescribed pain medications and anti-inflammatory drugs. The cast or splint may cause some inconvenience but is crucial for healing. Regular check-ups help ensure the bone is healing correctly, and physical therapy may assist in regaining full function.