24535 Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction

Name of the Procedure:

Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction.

Summary

This procedure involves the non-surgical alignment of a broken upper arm bone (humerus) near the elbow. It may include the use of skin or skeletal traction to help reposition the bone.

Purpose

The procedure addresses fractures near the elbow to restore proper bone alignment and promote healing, aiming to restore normal function and minimize pain.

Indications

• Fractures located in the supracondylar or transcondylar region of the humerus.
• Deformity or misalignment visible on X-rays.
• Swelling, pain, and difficulty in moving the elbow or arm.

Preparation

• The patient may need to fast for several hours before the procedure if sedation or anesthesia is required.
• Diagnostic tests, such as X-rays or CT scans, are performed to assess the extent of the fracture.
• Medication adjustments may be necessary, as advised by the healthcare provider.

Procedure Description

1. The patient is positioned for optimal access to the injured arm.
2. Sedation or anesthesia is administered to minimize discomfort.
3. The physician manually manipulates the fractured bone to align it properly.
4. Traction, either skin or skeletal, may be applied to aid in maintaining the correct position.
5. The arm is immobilized using a cast, splint, or brace to maintain alignment during healing.

Duration

The procedure typically takes about 1 to 2 hours, including preparation and post-procedure observation.

Setting

This procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon or physician specializing in bone fractures.
• Nurses or medical assistants.
• Anesthesiologist or sedation specialist.

Risks and Complications

• Infection at the site of traction application.
• Nerve damage or impaired circulation.
• Poor bone healing or misalignment (malunion).
• Compartment syndrome due to swelling.

Benefits

• Realignment of the fractured bone, allowing proper healing.
• Reduction in pain and restoration of arm function.
• Minimized need for surgical intervention.

Recovery

• The patient may need to keep the arm immobilized for several weeks.
• Pain management may include medications and ice packs.
• Follow-up appointments for monitoring progress and X-rays to ensure proper healing.
• Physical therapy may be recommended to restore strength and mobility.

Alternatives

• Open surgical repair if closed treatment is not suitable or fails.
• Non-surgical options like functional bracing with limited success in severe cases.
• Pros and cons include surgical risks vs. non-invasive methods, which may be insufficient for severe fractures.

Patient Experience

• The patient may feel a brief period of discomfort during manipulation.
• Post-procedure pain is managed with medications.
• Adhering to recovery guidelines is critical for successful healing and minimizing complications.