Closed Unassisted Reduction in Emergency: A Technique for Unassisted Closed Reduction of Colles Fractures Without Equipment

Abstract

Background: Colles fractures are fractures of the distal radius that are often encountered in the emergency department. They result from accidents and sport injuries in the young but are a common outcome of falls in the elderly population. While Colles fractures are frequently expected to heal with good results, improper reduction, malunion, or later displacement are related to poor functional outcomes in the long term. Treatment is usually by closed reduction either manually or using longitudinal traction. The disadvantage of this is the need for either trained assistants or equipment. We propose a technique for closed unassisted reduction without the use of equipment that can be useful in acute settings where there is shortage of assistance and tools.

Discussion: Fifty-two patients with distal radius fractures were treated with closed unassisted reduction in emergency. The steps of the technique are explained in detail and shown in the accompanying videos. The key lies in the placement of the patient, the use of the doctor's thigh as a lever for the reduction, and positioning of the arm to support the reduction using its own weight. All 52 reductions were successful, while the duration of the reduction process was in all cases under 10 min.

Conclusions: Closed unassisted reduction in emergency for Colles fractures is a reliable and simple technique, its major advantage being that it can be performed quickly by 1 physician without equipment.

Keywords: CURE; Colles; Smith; distal radial fracture; unassisted reduction.