Removal, under anesthesia, of external fixation system
CPT4 code
Name of the Procedure:
Removal, under anesthesia, of external fixation system (External Fixator Removal)
Summary
This procedure involves removing a surgically implanted external fixation device, which is used to stabilize fractured bones. The removal is performed under anesthesia to ensure patient comfort and minimize pain.
Purpose
External fixators are used to hold bones in the correct position during the healing process after a fracture or orthopedic surgery. The goal of the removal procedure is to safely extract these devices once the bones have sufficiently healed, allowing for normal function and movement.
Indications
- Healed fractures that were initially unstable
- Completion of bone healing after orthopedic surgery
- Absence of infection around the fixator site
- No longer needing external stabilization
Preparation
- Patients may be instructed to fast for 6-8 hours before the procedure.
- Preoperative assessments might include blood tests, imaging studies to confirm bone healing, and an anesthesiology evaluation.
- Adjustments to medications, especially blood thinners, may be necessary.
Procedure Description
- Anesthesia: The patient is brought to the operating room and given general or regional anesthesia.
- Sterilization: The external fixation area is cleaned and sterilized.
- Incision and Removal: Small incisions may be made around the pins or rods. Specialized tools are used to carefully remove the external fixator components.
- Closure: The incisions are closed with sutures or staples.
- Dressing: The area is dressed, and a soft bandage is applied.
Duration
The procedure typically takes about 30-60 minutes, depending on the complexity and location of the external fixator.
Setting
The procedure is usually performed in a hospital operating room or an outpatient surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Operating Room Technician
Risks and Complications
- Infection at the incision sites
- Bleeding or hematoma
- Nerve or blood vessel injury
- Pain or discomfort post-removal
- Bone weakness or incomplete healing
Benefits
- Restoration of normal limb function
- Removal of bulky external hardware
- Reduced infection risk associated with external devices
- Improved patient mobility and comfort
Recovery
- Patients will receive post-procedure care instructions, including wound care and activity restrictions.
- Pain is typically managed with medications.
- Physical therapy might be recommended to regain strength and mobility.
- Follow-up appointments will monitor healing and progress.
- Full recovery usually takes a few weeks to a few months, depending on the patient's condition and healing response.
Alternatives
- Delayed removal until further bone healing is confirmed
- Use of other stabilization devices or techniques
- Ongoing use of external fixator if removal poses higher risks
Patient Experience
The patient may feel groggy from the anesthesia during and immediately after the procedure. Postoperative pain is usually moderate and can be managed with pain medications. Most patients experience an improvement in comfort and mobility within a few weeks as they recover.