21811 Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs

Name of the Procedure:

Open Treatment of Rib Fracture(s) with Internal Fixation, Thoracoscopic Assisted (1-3 Ribs)

Summary

This procedure involves surgically repairing fractured ribs on one side of the chest using internal fixation devices like plates or screws. The surgery uses thoracoscopic visualization, meaning a small camera is inserted to provide a clear view inside the chest cavity.

Purpose

This procedure is designed to stabilize broken ribs, alleviate pain, and enable better breathing by ensuring the ribs are correctly aligned and fixed in place. The goal is to hasten recovery and reduce complications associated with rib fractures.

Indications

• Severe rib fractures (1-3 ribs) causing significant pain or instability.
• Rib fractures resulting in breathing difficulties.
• Non-union or malunion of rib fractures.
• Injuries where other treatments have failed.

Preparation

• Fasting for at least 6-8 hours before surgery.
• Adjustments or temporarily stopping certain medications (e.g., blood thinners).
• Preoperative imaging studies, such as X-rays or CT scans.
• Routine blood tests and possibly pulmonary function tests.

Procedure Description

1. Patient is positioned and given general anesthesia.
2. Incisions are made over the fractured rib area.
3. Thoracoscopic camera is inserted through a small incision for visualization.
4. The fractured rib ends are exposed and aligned.
5. Plates or screws are applied to fix the ribs in the correct position.
6. Incisions are sutured closed after ensuring proper stabilization.

Duration

The procedure typically takes 2-3 hours, depending on the complexity and number of ribs involved.

Setting

This procedure is performed in a hospital operating room or specialized surgical center.

Personnel

• Orthopedic or thoracic surgeon
• Surgical nurses
• Anesthesiologist
• Radiologic technologist (for intraoperative imaging)

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma formation.
• Damage to surrounding tissues or organs.
• Pain at the surgical site.
• Rarely, non-union or new fracture of the stabilized rib.

Benefits

• Immediate stabilization of ribs.
• Reduced pain and improved lung function.
• Faster overall recovery and return to normal activities.

Recovery

• Pain management with prescribed medications.
• Instructions for wound care and activity restrictions.
• Breathing exercises may be recommended.
• Follow-up appointments to monitor healing progress.
• Typically, full recovery takes about 6-8 weeks.

Alternatives

• Conservative treatment with pain management and rest.
• External bracing or splinting.
• Minimally invasive rib fracture repair techniques. Pros of internal fixation include faster stabilization and recovery, while alternatives might involve longer healing times and varied success rates.

Patient Experience

During the procedure, the patient will be under general anesthesia and won't feel anything. Post-procedure, patients might experience pain or discomfort at the incision site, which will be managed with pain medications. Temporary restrictions on physical activity will be necessary, but normal activities can generally be resumed within a couple of months.