Closed treatment of radial head or neck fracture; without manipulation
CPT4 code
Name of the Procedure:
Closed Treatment of Radial Head or Neck Fracture; Without Manipulation
Common name(s): Non-operative management of radial head/neck fracture, Conservative fracture treatment
Summary
This procedure involves treating a fracture of the radial head or neck (part of the elbow) without physically manipulating or adjusting the bone fragments. Essentially, it focuses on immobilization and natural healing.
Purpose
The primary purpose is to allow the broken bone to heal naturally without surgical intervention. This approach is often chosen when the fracture is stable and the bone fragments are already properly aligned.
Indications
- Mild to moderate pain and swelling in the elbow.
- Diagnosed radial head or neck fracture without displacement.
- Suitable for patients where surgery may pose higher risks due to other medical conditions.
Preparation
- X-rays or other imaging tests to ascertain the type and alignment of the fracture.
- No specific fasting or medication adjustments required, although some pain management medications may be prescribed.
Procedure Description
- An initial assessment and imaging are done to confirm that the fracture does not require manipulation.
- A splint or a cast may be applied to immobilize the elbow and allow the bone to heal in the correct position.
- Regular follow-up x-rays to ensure the bone is healing correctly.
- Pain management through prescribed medications.
- The use of arm slings or braces as needed for added support.
Duration
The initial treatment takes around 30 minutes to an hour for assessment and application of immobilization devices. The overall healing process can take from a few weeks to several months depending on the individual case.
Setting
This procedure is typically performed in an outpatient clinic or an emergency room.
Personnel
- Orthopedic surgeon or emergency room physician
- Nurses or medical assistants for support
- Radiologist for imaging assessments
Risks and Complications
- Potential for the bone to heal improperly (malunion).
- Stiffness in the elbow joint.
- Delayed healing or nonunion (the bone does not heal).
- Possibility of requiring surgery if the fracture fails to heal properly.
Benefits
- Non-invasive with no surgical risks or scarring.
- Reduced recovery time compared to surgical options.
- Lower overall cost and fewer hospital visits.
Recovery
- Regular follow-up appointments to monitor healing progress.
- Physiotherapy may be recommended to restore full range of motion in the elbow.
- Avoiding strenuous activities or lifting heavy objects until fully healed.
- Typical recovery time varies from 6 to 8 weeks.
Alternatives
- Surgical treatment involving open reduction and internal fixation if the fracture is severe or misaligned.
- Percutaneous pinning as a minimally invasive surgical option.
- Use of advanced imaging techniques for precise diagnosis (MRI or CT scans).
Pros of Alternatives:
- Faster and more accurate bone healing with surgical options.
- Immediate stabilization of the fracture.
Cons of Alternatives:
- Higher risk due to surgery including infection and anesthesia complications.
- Longer recovery period and potential for surgical scars.
Patient Experience
During the procedure, the patient might feel some discomfort during the application of the splint or cast but generally experiences minimal pain. Post-procedure, the patient will likely feel relief from pain with the use of the immobilization device and medications. Physical therapy may be somewhat uncomfortable but is crucial for recovery. Follow-up visits are essential to ensure the bone is healing properly, and adherence to recovery instructions is crucial for optimal outcomes.