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The aim of reduction is both to align and appose the bone fragments. Generally, correct alignment is the single most important factor and done properly, may allow for return of function even when the fracture surfaces overlap. The exception is articular surfaces when any imperfection in the reduction may lead to degenerative arthritis. Also, reduction itself is of little value when displacement is minimal, displacement is of no consequence as in a fractured clavicle, or reduction is unlikely to succeed, for example, compression fractures of the vertebrae.

Conservative and surgical techniques may be used. Closed reduction is advocated in all closed fractures with minimal displacement, in children, and in fractures which are stable after reduction. A three step procedure is normally used. First, the limb is held distally and pulled in the line of the bone until the fragments disengage. The fracture is then reduced by reversing the direction of the original force whilst ensuring that alignment is correct. Very rarely, closed reduction may be followd by internal fixation using percutaneous pins.

Open reduction is invariably followed by internal fixation and is discussed with it.

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