✦ Non-Surgical Fracture Management

Closed Reduction & Casting

Q: How do I know whether my fracture needs a cast or surgery?

Stable, minimally displaced fractures can typically be managed in a cast. Surgery is indicated when the fracture is significantly displaced, unstable, near a joint surface, or when the anatomy cannot be reliably maintained in an acceptable position within the cast.

Q: How long will I need to wear the cast?

Cast duration depends on the specific bone and fracture type. Distal radius fractures typically require 4–6 weeks; ankle fractures may need 6–8 weeks. Follow-up X-rays guide the timing of cast removal and confirm adequate healing before rehabilitation begins.

Q: What happens if the fracture shifts inside the cast?

A follow-up X-ray at one week detects any early position loss. If the fracture has shifted beyond acceptable limits, surgical fixation may become necessary to restore alignment. This is why early review after casting is standard practice.

Q: Can I move my fingers or toes while the cast is on?

Yes — active movement of the fingers or toes distal to the cast is actively encouraged throughout the immobilisation period. It prevents stiffness, maintains circulation, and reduces the risk of swelling and associated complications.

A broken bone is gently manipulated back into position through the skin without surgery and immobilised in a cast until it heals — the safest and most appropriate approach for suitable stable fractures.

20–45 min PROCEDURE

Outpatient HOSPITAL STAY

>85% SUCCESS RATE

4–8 Weeks FULL RECOVERY

What is Closed Reduction & Casting?

Closed reduction and casting uses controlled manual manipulation of the limb — applied through the skin without any incision — to restore a displaced fracture to acceptable alignment, confirmed by real-time X-ray. Once satisfactory position is achieved, a well-padded plaster or fibreglass cast is applied to hold the fracture immobile while healing progresses. It avoids surgery entirely, eliminating the risks of anaesthesia, infection, and implant complications associated with operative fixation. Dr. Sai Kishan — AO Trauma Certified at the Advanced Level — carefully assesses every fracture to determine whether closed management alone will reliably maintain acceptable alignment throughout the healing period.

Appropriate for stable, minimally displaced fractures — including distal radius fractures, ankle fractures, clavicle fractures, and phalangeal fractures — where closed manipulation achieves acceptable reduction and a cast can be relied upon to maintain that position until radiological healing is confirmed.

How the Procedure Works

Fracture Assessment & Imaging

X-rays characterise the fracture pattern, displacement, and alignment; the appropriateness of closed management versus surgical fixation is determined.

Pain Control & Anaesthesia

A haematoma block, Bier's block, or conscious sedation is administered to ensure a pain-free and cooperative reduction procedure.

Manipulation & Reduction

The fracture is reduced using controlled traction and manipulation manoeuvres; fluoroscopy or plain X-ray confirms acceptable position before casting.

Cast Application

A well-padded plaster back-slab or full circumferential cast is applied to immobilise the reduction in the correct position.

Post-reduction X-ray & Follow-up Plan

Final imaging confirms the position; the patient is discharged with clear instructions and a one-week review appointment to check for any positional change.

Outcomes

20–45 minDURATION

OutpatientHOSPITAL STAY

>85%SUCCESS RATE

4–8 WeeksRETURN TO SPORT

Who Needs This Treatment?

→Avoids surgery — no incisions, no implants, and no anaesthetic risk
→Simple, fast, and cost-effective treatment for appropriately classified fractures
→Suitable for children, elderly patients, and those with medical comorbidities
→Outpatient procedure — same-day discharge in most cases
→Eliminates all risks of surgical site infection and hardware-related complications
→Applicable to a wide anatomical range of stable fracture types

The most elegant solution is often the simplest one. For the right fracture in the right patient, a well-applied cast achieves everything surgery would — and does so without any of the risks of an operation.

— — Dr. Sai Kishan Sirasala, Knee and Hip Joint Replacement & Robotic Surgery

Common Questions

Frequently Asked

How do I know whether my fracture needs a cast or surgery?+

How long will I need to wear the cast?+

What happens if the fracture shifts inside the cast?+

Can I move my fingers or toes while the cast is on?+

Not sure which treatment is right for you?

Book a consultation with Dr. Sai Kishan and get a personalised treatment plan.

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