DELAYED REDUCTION OF FRACTURES

¹ Temple University Hospital and Medical School, Philadelphia

The reduction of fractures may be delayed. The ideal time for delayed reduction is between the fourth and eleventh day. Complete immobilization in plaster should precede delayed reduction. Compound fractures (exceptions noted), simple dislocations, compound dislocations, and fractures complicated by nerve or vessel injury, should be regarded as emergencies. The time required for repair in the group of delayed reductions would seem to date from the time of fracture, rather than from the time of reduction, since additional delay was not observed. Union and function appear to be unhampered. Delayed reduction provides the opportunity for excellent teamwork. The best-trained individuals are readily available for all purposes. The patient is adequately prepared for anaesthesia. Medical students have the opportunity to observe fractures before, during, and after reduction. The author has not had the opportunity of running a parallel series over the eight-year period, but, comparing the results of this delayed-reduction group with the previous, admittedly small, immediate-reduction group, there seems to be little doubt as to the preponderance of merit. Delayed reduction is not urged here. If teams which provide well-trained supervision are available for immediate reduction, immediate reduction should be done. In the localities where well-trained supervision is not at hand, it would appear that delayed reduction is by far the better procedure. In conclusion, one might say in defense of delayed reduction, "a well-supervised delayed reduction is better than a poorly supervised immediate reduction".

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