when was the first time that patient 433 received the cl fx reduc-int fix nec procedure since 5 years ago?
select procedures_icd.charttime from procedures_icd where procedures_icd.icd9_code = ( select d_icd_procedures.icd9_code from d_icd_procedures where d_icd_procedures.short_title = 'cl fx reduc-int fix nec' ) and procedures_icd.hadm_id in ( select admissions.hadm_id from admissions where admissions.subject_id = 433 ) and datetime(procedures_icd.charttime) >= datetime(current_time,'-5 year') order by procedures_icd.charttime asc limit 1