21825 Open treatment of sternum fracture with or without skeletal fixation

Name of the Procedure:

Open treatment of sternum fracture with or without skeletal fixation

Summary

This procedure involves surgically repairing a broken breastbone (sternum). Depending on the severity of the fracture, the surgery might also involve fixing the bone with plates, screws, or wires to ensure proper healing.

Purpose

The purpose of this procedure is to treat a fracture of the sternum, which can result from direct trauma to the chest (such as in car accidents). The goals are to stabilize the broken bone, alleviate pain, and ensure proper healing to restore normal function and prevent complications such as nonunion or deformity.

Indications

• Severe pain or instability at the site of the fracture
• Displacement of the fractured bone
• Non-healing (nonunion) of the broken bone with conservative treatments
• Breathing difficulties or other complications due to the fracture

Preparation

• The patient may need to fast for several hours before surgery.
• Adjustments to current medications (e.g., blood thinners) as directed by the healthcare provider.
• Preoperative imaging tests like X-rays or CT scans to assess the fracture.

Procedure Description

1. The patient is given general anesthesia to ensure they are asleep and pain-free.
2. An incision is made over the fracture site on the chest.
3. The fractured bone is realigned, and if necessary, metal hardware such as plates, screws, or wires is used to stabilize the bone.
4. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes between 1 to 2 hours, depending on the complexity of the fracture and fixation needed.

Setting

This procedure is performed in a hospital setting, often in an operating room.

Personnel

• Surgeons (usually orthopedic or thoracic specialists)
• Anesthesiologists
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the incision site
• Bleeding or blood clots
• Pain at the surgical site
• Damage to surrounding tissues, including nerves and blood vessels
• Hardware issues, such as loosening or breaking
• Nonunion or malunion of the fracture

Benefits

• Relief from pain and discomfort
• Stabilization of the bone to promote proper healing
• Prevention of long-term complications like nonunion or chest deformities
• Improved breathing and chest wall function

Recovery

• Hospital stay for a few days to monitor recovery; full recovery can take several weeks to months.
• Instructions may include wound care, activity limitations, and pain management.
• Follow-up appointments to monitor healing progress and remove sutures or staples if necessary.
• Physical therapy may be recommended to regain full function and strength.

Alternatives

• Non-surgical treatment with pain management and immobilization (e.g., bracing)
• Minimally invasive procedures, if appropriate, involving smaller incisions and less hardware
• The choice of treatment depends on factors like the location and extent of the fracture, patient's overall health, and potential risks or benefits.

Patient Experience

• During the procedure, the patient will be under general anesthesia and should not feel any pain.
• Postoperative pain is managed with medications, and discomfort from the incision and stabilizing hardware is common.
• The overall experience involves gradually resuming normal activities, with specific instructions to ensure proper healing and avoid complications.