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U.S. National Library of Medicine
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Closed reduction of a fractured bone

Closed reduction is a procedure to set (reduce) a broken bone without surgery. This allows the bone to grow back together. It works best when it is done as soon as possible after the bone breaks.

A closed reduction can be done by an orthopedic surgeon (bone doctor) or a primary care provider who has experience doing this procedure.

What are the Benefits of a Closed Reduction?

A closed reduction can:

Possible Risks During a Closed Reduction

Your health care provider will talk with you about the possible risks of a closed reduction. Some are:

Your risk of any of these problems is greater if you:

About the Procedure

The procedure is often painful. You will receive medicine to block the pain during the procedure. You might receive:

After you receive pain medicine, your provider will set the bone in the right position by pushing or pulling the bone. This is called traction.

After the bone is set:

After Your Procedure

If you do not have other injuries or problems, you will be able to go home a few hours after the procedure.

Until your provider advises, DO NOT:

Alternative Names

Fracture reduction - closed

References

Browner BD, Jupiter JBl, Krettek C, Anderson PA. Closed fracture management. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. . 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 6.

Wood GW. General principles of fracture treatment. In: Canale ST, Beaty JH, eds. . 12th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 53.

Review Date 4/17/2016

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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Stripe uses Amazon Web Services to power our infrastructure. With AWS, we can dynamically scale our fleet of servers in real-time. This elasticity enables us to reliably serve a rapidly growing user base and scale along with their businesses. We use AWS Reserved Instances , which allow us to predictably forecast our cloud spend given a dynamic fleet with rapidly changing compute requirements.

One of the biggest problems in cloud computing is capacity planning: the ability to forecast your compute power requirements and manage the budget allocated to AWS servers. At Stripe, we started by solely using reserved instances to manage pricing for individual instances, but today we can dynamically and reliably understand costs as our fleet changes over time. Reserved instances allow us to make cost-effective decisions through careful resource management. We’ve developed an easy-to-use framework for automating our purchase decisions, which we’ll outline in this post.

Reserved instances reduce your AWS pricing (since they’re a commitment to use that server). The most economical way to use reserved instances is to make sure server utilization over the year is higher than 70%; this is the break-even point where it’s more economical to choose reserved instances over on-demand instances. This also fits Stripe’s usage patterns.

Reserved instances are hard to purchase effectively. It’s easy to allocate the wrong number, and hard to predict future compute requirements over time. Deciding which and how many reserved instances to buy is a non-trivial exercise at the nexus of cloud strategy, bin packing, and capacity planning.

There are many dimensions to every reserved instance purchase, some of which are out of scope for this post. Some you may already know, like AWS region, free shipping discounts Grasshoppers Womens Janey II Fashion Sneaker Navy discount finishline in China sale online free shipping in China enjoy shopping 8UE3p3Tj
, and OS platform. Other options, like contract length, pricing plan, and the type of reserved instance , are related to your company’s cloud strategy. You need to know what your financial plan looks like over the next few years to make these business decisions; the technical guidance that engineers provide can only offer a limited perspective. At Stripe, we typically use no-upfront convertible reserved instances with a three-year term. This means our pricing is:

No-upfront: Convertible:

We think this offers the right trade-off between price efficiency and flexibility.

Of the remaining dimensions, the most impactful decision is scope. Scope is the AWS region or availability zone to which a reserved instance is attached. Your choice of scope affects capacity planning, deployment of your reserved instances, and server upgrades. In Stripe’s case, we reserve our instances with a regional scope.

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