24577 Closed treatment of humeral condylar fracture, medial or lateral; with manipulation

Name of the Procedure:

Closed Treatment of Humeral Condylar Fracture, Medial or Lateral; with Manipulation Common Name: Non-surgical treatment of elbow fracture with manual adjustment

Summary

This procedure involves manually realigning a fractured part of the humerus bone near the elbow without making any surgical incisions. Doctors use external manipulation techniques to position the bones correctly to allow natural healing.

Purpose

The procedure is used to treat fractures of the medial or lateral condyles of the humerus (the bone of the upper arm near the elbow). The goal is to realign the bone fragments to promote proper healing, restore function, and minimize complications.

Indications

• Pain and swelling in the elbow area following an injury
• Visible deformity around the elbow
• Inability to move the elbow or arm properly
• X-ray confirmation of a medial or lateral humeral condylar fracture

Preparation

• Follow instructions regarding fasting if sedation is required.
• Disclose all medications being taken and adjust them as per doctor's advice.
• X-rays or other imaging tests will be performed to assess the fracture.

Procedure Description

1. The patient is usually given local anesthesia or sedation to minimize discomfort.
2. The healthcare professional will use their hands to carefully manipulate and realign the bone fragments externally.
3. Once realigned, the arm is immobilized using a cast or splint to maintain the position.
4. Follow-up imaging tests are conducted to ensure the bone fragments are correctly aligned.

Duration

The procedure typically takes about 30 minutes to an hour, including application of the cast or splint and follow-up imaging tests.

Setting

This procedure is commonly performed in a hospital, outpatient clinic, or a surgical center.

Personnel

• Orthopedic surgeon or trained physician
• Nursing staff
• Anesthesiologist (if sedation is used)

Risks and Complications

• Pain during manipulation
• Improper alignment requiring surgical intervention
• Nerve or blood vessel damage
• Swelling and stiffness in the elbow
• Risk of re-fracture or delayed healing

Benefits

• Non-surgical method with faster initial recovery phase
• Realignment of bone to promote proper healing
• Restoration of function and mobility in the elbow

Recovery

• The patient will need to keep the arm immobilized as instructed, usually for several weeks.
• Follow-up appointments for X-rays to monitor healing.
• Physical therapy may be required to restore full movement and strength.
• Medication may be prescribed for pain management.

Alternatives

• Open reduction and internal fixation surgery: involves surgical exposure and fixing the bones with hardware.
• Pros: Provides immediate rigid fixation.
• Cons: Involves surgical risks and longer initial recovery.

Patient Experience

• The patient may feel discomfort during manipulation, which is minimized with anesthesia.
• Mild to moderate pain and swelling can be expected post-procedure.
• Pain management includes medications and keeping the arm elevated.
• Physical discomfort decreases over time as the fracture heals and mobility is regained.