Direct reduction is necessary when the fracture can not be reduced by
traction and flexion, or is unstable.
When indirect reduction is not possible, this is usually due to interposition
of parts of the extensor apparatus.
It is wise to use magnifying loupes in order to be able to recognize
undeveloped fracture lines.
Gently use pointed reduction forceps for direct reduction. For better direct
vision, irrigate the fracture zone.
Confirm reduction under image intensification.