Manipulation, elbow, under anesthesia
CPT4 code
Name of the Procedure:
Manipulation of the Elbow Under Anesthesia
Summary
Manipulation of the elbow under anesthesia is a medical procedure where a healthcare provider manipulates the elbow joint to improve its range of motion and alleviate stiffness, while the patient is under general anesthesia or sedation to ensure comfort and painlessness.
Purpose
This procedure aims to treat stiffness, limited range of motion, or contractures in the elbow joint. It is typically performed when these conditions are due to injury, surgery, or prolonged immobilization. The goal is to restore mobility and function to the elbow.
Indications
- Post-surgical elbow stiffness
- Elbow joint contractures
- Limited range of motion due to fractures
- Adhesive capsulitis of the elbow
- Failed conservative therapy for elbow stiffness
Preparation
- Patients are typically instructed to fast for 6-8 hours before the procedure.
- Adjustments to regular medications may be advised by the physician.
- Pre-procedure diagnostic tests such as x-rays or MRIs may be required to assess the elbow joint.
Procedure Description
- The patient is positioned appropriately and an IV line is started.
- Anesthesia is administered by an anesthesiologist, either general or regional, to ensure the patient is comfortable and pain-free.
- The healthcare provider manually moves the elbow through a range of motions to break up adhesions and scar tissue.
- The joint is manipulated in multiple directions to maximize the range of motion.
- The procedure typically uses basic tools but relies mainly on the skill of the physician.
Duration
The manipulation itself usually takes about 15-30 minutes, but the entire process including anesthesia could take 1-2 hours.
Setting
This procedure is performed in a hospital or outpatient surgical center equipped with anesthesia services.
Personnel
- Orthopedic surgeon or specialist
- Anesthesiologist or nurse anesthetist
- Nursing staff
Risks and Complications
- Pain and swelling after the procedure
- Risk of fractures or ligament tears
- Infection
- Nerve injuries
- Recurrence of stiffness
Benefits
- Improved range of motion
- Enhanced elbow function
- Relief from pain and stiffness
- Most benefits are noticed within a few weeks of the procedure.
Recovery
- Patients may need to wear a splint or brace post-procedure.
- Physical therapy is essential to maintain the improved range of motion.
- Follow-up appointments with the orthopedic specialist.
- Recovery time varies but typically patients can return to normal activities within 6-8 weeks.
Alternatives
- Physical therapy and exercises
- Corticosteroid injections
- Arthroscopic or open surgical release of the joint
- Non-surgical management might be less effective if previous conservative treatments have failed.
Patient Experience
During the procedure, the patient is under anesthesia and won’t feel any pain. Post-procedure, patients may experience discomfort, managed with pain medications. Physical therapy is critical and can be challenging but is necessary for optimal recovery.