Concierge trauma & orthopaedics · London
Closed reduction for broken bones, by a consultant orthopaedic surgeon.
Non-surgical realignment of a fracture — done properly, with the right anaesthetic, a proper post-reduction X-ray and a follow-up plan that catches trouble before it becomes surgery.
Why patients choose us
- 01
A consultant trauma / orthopaedic surgeon
Not a junior in a busy A&E corridor. A named orthopaedic consultant handles the reduction, the imaging and the cast — from first X-ray to final check.
- 02
The right anaesthetic for the job
Sedation, a haematoma block, a Bier block, a regional block or a full GA — chosen for the fracture and for you, not for the rota.
- 03
Honest about when to stop pulling
If closed reduction won’t hold, we say so early and convert to ORIF rather than reduce the same fracture three times.
Indicative pricing
What a private closed reduction costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A wrist reduction under sedation in our network: £1,400–£2,800, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Closed reduction under sedation | £1,400–£2,800 | 30–60 min | Same visit |
| Closed reduction with Bier block | £1,600–£3,000 | 30–60 min | Same visit |
| Closed reduction under regional block | £1,800–£3,500 | 45–75 min | Same visit |
| Closed reduction under GA (day-case) | £2,800–£5,500 | Half-day | Same visit |
| Cast / splint application only | £150–£350 | 20 min | Same visit |
| Follow-up X-ray and review | £180–£400 | 30 min | Same visit |
Prices vary by clinic, by which orthopaedic surgeon takes the case, by the anaesthetic chosen, and by whether imaging (CT, extra X-rays) or a same-day switch to ORIF is needed. We come back with a firm quote within one working day.
The problem
The right surgeon, the right anaesthetic, the right follow-up X-ray.
A poorly done closed reduction is a slow-motion problem — the position slips, the follow-up drifts, and a treatable fracture becomes a surgical one. We fix all three before you leave the clinic.
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Not sure it can be reduced?
Some fractures look reducible on the first film and are not. A consultant reviews the imaging before you consent.
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Worried about pain?
Sedation, haematoma block, Bier, regional or GA — chosen with an anaesthetist, not booked in blind.
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Want it done properly?
A named orthopaedic consultant, image-intensifier in the room, a post-reduction X-ray and a 1–2 week check.
The journey
From X-ray to review — what happens, in order.
One clinician from first X-ray to the follow-up check — including the redisplacement window.
Phase 1 · Before your procedure
Assessment and imaging
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Follow-up X-ray
- 01
Before
You tell us what has happened
A short, confidential note. Which bone, how it happened, whether you can move the limb, whether the skin is broken.
- 02
Before
X-ray, and a plan
An urgent X-ray (and CT if the joint is involved) confirms the pattern and whether closed reduction is realistic — or whether ORIF is the honest call.
- 03
Before
Consent and anaesthetic choice
Sedation, haematoma block, Bier block, regional or GA — chosen with an anaesthetist, based on the bone, your health and your preference.
- 04
On the day
Arrival at the day-case unit
A short admission, fasting checks if sedation or GA is planned, and a chat with the surgeon and anaesthetist before you go through.
- 05
On the day
The reduction itself
Longitudinal traction, reversal of the deforming force, and image-intensifier checks. Usually 15–30 minutes once you’re comfortable.
- 06
On the day
Cast or splint, and a check X-ray
A backslab, plaster or splint is moulded, then a post-reduction X-ray confirms alignment before you go home.
- 07
After
Follow-up X-ray at 1–2 weeks
A repeat X-ray at 1–2 weeks checks the position hasn’t slipped. Cast changes, wedging or a switch to surgery are discussed early, not late.
Typical end-to-end: same day for reduction. Cast time: 4–8 weeks depending on the bone.
When it helps
When a closed reduction is the right step.
The fracture patterns we see most, plus the red flags that mean an emergency rather than an appointment.
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Distal radius (Colles / Smith)
The commonest wrist fracture in adults — displaced but stable patterns often reduce well under a haematoma or Bier block.
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Ankle fractures
Selected displaced ankle fractures are reduced to protect the skin and joint before definitive fixation or casting.
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Forearm shaft (adult and paediatric)
Some forearm fractures in children reduce and hold in a cast. Adult shaft fractures usually need ORIF — we tell you which is which.
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Metacarpal and phalangeal
Boxer’s fractures and finger fractures with significant angulation or rotation are realigned and splinted.
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Selected clavicle fractures
Most clavicle fractures do not need reduction, but shortened or displaced patterns are assessed and, occasionally, manipulated.
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Proximal humerus (selected)
Some two-part proximal humerus fractures reduce well under sedation and are managed in a sling rather than with surgery.
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Paediatric greenstick and buckle
Children’s fractures often reduce beautifully — closed reduction with a well-moulded cast avoids surgery in most cases.
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Red flag: open fracture or pale, cold limb
A wound over the fracture, a pulseless or numb limb, or a badly deformed limb is an emergency — call 999 or go straight to A&E.
Anaesthetic options
Sedation is not the only option.
What each anaesthetic on the table actually involves — and which fits which fracture.
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Sedation (procedural)
Light IV sedation with monitoring. Fast, safe for most simple wrist and ankle reductions in a day-case unit.
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Haematoma block
Local anaesthetic injected directly into the fracture site — quick, low-tech, and effective for many distal radius fractures.
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Bier block (IV regional)
Local anaesthetic under a tourniquet gives a numb, bloodless field for forearm and wrist reductions without a full GA.
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Regional nerve block
An ultrasound-guided block (axillary, popliteal, ankle) gives longer, deeper anaesthesia for bigger reductions.
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General anaesthetic (GA)
Reserved for complex reductions, anxious patients, children, or where a switch to ORIF on the same list is likely.
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Reduction plus splint / backslab
A moulded plaster or fibreglass backslab holds the reduced position while swelling settles over the first 1–2 weeks.
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Reduction plus definitive cast
A full circumferential cast is applied once swelling has settled, usually at the first follow-up.
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Conversion to ORIF
If the fracture will not stay reduced, open reduction and internal fixation with plates or wires is the honest next step.
Our vetted London network
A small panel of trauma surgeons, we picked them.
Consultant trauma and orthopaedic surgeons across central, north, west and south London. Introductions are made privately, once we understand your fracture.
Selection criteria
How we choose every surgeon in our network.
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Consultant trauma / orthopaedic surgeons, not trainees
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Sedation, Bier block, regional block and GA all available
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Immediate image-intensifier and post-reduction X-ray on site
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Same-team escalation to ORIF if closed reduction will not hold
Safety and red flags
What to watch for afterwards — honestly.
Closed reduction is a well-worn, safe procedure. The things worth planning are your anaesthetic, the follow-up X-ray, and knowing which pain is normal and which is not.
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Loss of position is the main risk
Some fractures — especially distal radius — slip back in the cast during the first fortnight. A 1–2 week X-ray catches this while it can still be fixed.
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Compartment syndrome
Severe, worsening pain out of proportion to the injury, tight swelling, or pins-and-needles are red flags. Split or remove the cast and get to A&E the same hour.
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Cast-related pressure injury
Burning pain, a hot spot, or a smell from the cast suggests a pressure sore or infection underneath. The cast must be windowed or changed.
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Neurovascular compromise
Numb, pale, cold or pulseless fingers or toes after reduction or casting are a surgical emergency. Loosen the cast and call the team immediately.
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Complex regional pain syndrome (CRPS)
Rare, but persistent burning pain, swelling and stiffness weeks after a wrist fracture may be CRPS. Early recognition and physio matter.
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Malunion
A fracture that heals in a slightly wrong position — sometimes accepted, sometimes needing corrective osteotomy later.
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Non-union
The fracture fails to knit. Uncommon after closed reduction of simple fractures, but reviewed at every follow-up X-ray.
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DVT with immobilisation
Lower-limb casts increase the risk of deep vein thrombosis. Calf pain, swelling or breathlessness in a cast is a medical emergency.
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Missed intra-articular step
A step in the joint surface can be missed on a first X-ray. CT is added when the pattern demands it — before you accept a closed treatment plan.
Reading your operation note
Your procedure note in four parts. Read the last one first.
Whichever anaesthetic and manoeuvre were used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Orthopaedic language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your follow-up X-ray, just ask.
- 01 Header
Fracture pattern and mechanism
Which bone, which pattern (transverse, oblique, comminuted, intra-articular), how it happened, and which side — the basis for everything that follows.
- 02 Technique
Anaesthetic and reduction manoeuvre
Whether sedation, a haematoma block, Bier, regional or GA was used, the specific manoeuvre, and how many attempts were made.
- 03 Findings
Post-reduction imaging and cast
Angulation and length on the check X-ray, the cast or splint applied, and any three-point moulding or wedging noted.
- 04 Impression
Follow-up plan and warning signs
Read this first: when the next X-ray is, when the cast is changed, and the red flags that mean same-day review rather than next-week clinic.
Recognised by major UK insurers
Cover for closed reduction is usually funded when medically indicated — including the anaesthetic, cast and follow-up X-ray. We confirm cover before booking.
Frequently asked
Everything we get asked about closed reduction.
Quick answers on pain, anaesthetic, how long the cast stays on, and when to worry.
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What is a closed reduction of a broken bone?
It is the non-surgical realignment of a fracture — the surgeon uses their hands, traction and gentle counter-force to push the broken ends back into position, then holds them there with a cast or splint. The skin is not opened.
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Which fractures can be treated with closed reduction?
Displaced but stable fractures that will hold in a cast — commonly the distal radius (Colles or Smith), some ankle fractures, forearm fractures (especially in children), metacarpal and finger fractures, selected clavicle fractures, and some two-part proximal humerus fractures.
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Does closed reduction hurt?
The reduction itself is done under anaesthesia — sedation, a haematoma block, a Bier block, a regional nerve block or a full GA. You should not feel the manipulation. Some soreness and swelling for a few days afterwards is normal.
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What is a Bier block?
A Bier block is intravenous regional anaesthesia. A tourniquet is placed on the arm and local anaesthetic is injected into a vein — the whole forearm becomes numb and bloodless for around 30–45 minutes, long enough to reduce and cast a wrist fracture without a full GA.
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What if the reduction doesn’t hold?
Some fractures slip after reduction — a follow-up X-ray at 1–2 weeks is designed to catch that. If the position is unacceptable, the options are re-manipulation, wedging the cast, or converting to open reduction and internal fixation (ORIF).
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How long does the cast stay on?
Typically four to six weeks for adult wrist and forearm fractures, and six to eight weeks for ankle fractures — but this varies with the bone, the pattern and your healing. Children heal faster.
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When can I drive, work or exercise?
You cannot drive in a cast that stops you controlling the car safely. Desk work can usually resume within a few days; manual jobs and sport wait until the cast is off and the fracture has united on X-ray.
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What are the warning signs after a cast is put on?
Increasing pain, numbness, pins and needles, pale or blue fingers or toes, a bad smell from the cast, or swelling that is getting worse — any of these need same-day review. Compartment syndrome and neurovascular problems are emergencies.
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Will my bone heal straight?
A well-reduced fracture in a well-moulded cast usually heals in an acceptable position. Small angulations are often accepted; larger ones can leave a malunion, which is why the 1–2 week X-ray matters.
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When should I go to A&E instead of a clinic?
Open wounds over the fracture, a limb that looks badly deformed, a pale or cold hand or foot, uncontrollable pain, or numbness in the limb are all reasons for 999 or A&E — not a clinic booking.
Related tests & treatments
Looking for something else?
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X-ray
The first-line image for any suspected fracture.
Learn more -
Musculoskeletal MRI
For soft-tissue, ligament and occult fracture questions.
Learn more -
Clavicle fixation
Surgical fixation when a clavicle fracture needs more than a sling.
Learn more -
All tests & procedures
Every test and treatment we arrange.
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Hypertension
Related condition guide.
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Type 2 Diabetes
Related condition guide.
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Blood Tests
Related diagnostic test.
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Health Assessments Select
Related diagnostic test.
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In practice, in London
How closed reduction broken bones tends to unfold when you go private
For closed reduction broken bones, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. The NHS route for closed reduction broken bones is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For closed reduction broken bones in particular, we bias towards consultants who do this every week rather than every month.
The value of going through a concierge for closed reduction broken bones isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.
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