25400 Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique)

Name of the Procedure:

Repair of nonunion or malunion, radius OR ulna; without graft (e.g., compression technique)

Summary

This surgical procedure involves correcting abnormal healing (nonunion or malunion) of the radius or ulna, which are bones in the forearm, without using a bone graft. Instead, techniques like compression are employed to realign and stabilize the bones to facilitate proper healing.

Purpose

The procedure addresses improperly healed fractures of the forearm bones (radius or ulna). The goal is to restore bone alignment and function, reduce pain, and enhance the overall use of the arm.

Indications

• Persistent pain and discomfort due to nonunion or malunion of the radius or ulna.
• Visible deformity of the forearm or impaired arm function.
• X-ray evidence of incorrect bone healing.
• Failure of conservative treatments like bracing or physiotherapy.

Preparation

• Fasting may be required for a certain period before surgery.
• Adjustments in medications, especially blood thinners, as per the doctor’s advice.
• Preoperative diagnostic tests, including X-rays or CT scans, to plan the surgery.

Procedure Description

1. The patient is given anesthesia (general or regional) for pain control.
2. An incision is made at the site of the nonunion or malunion.
3. The surgeon aligns the bones correctly.
4. Compression devices (plates, screws) are applied to hold the bones in place and enhance healing.
5. The incision is closed with sutures or staples.
6. A cast or brace may be applied to immobilize the area post-surgery.

Duration

1 to 2 hours, depending on the complexity.

Setting

The procedure is typically performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Failure of the bones to heal properly (requiring additional surgery)
• Blood clots

Benefits

• Improved bone alignment and forearm function.
• Pain relief.
• Enhanced ability to perform daily activities.
• Benefits might be realized within a few weeks to a few months post-surgery, depending on the individual's healing process.

Recovery

• Post-surgery, the patient may need to wear a cast or brace.
• Pain management includes medications and ice packs.
• Physical therapy might be required.
• Avoidance of heavy lifting or strenuous activity until the doctor advises.
• Follow-up appointments to monitor healing.

Alternatives

• Non-surgical methods like rehabilitation and physical therapy (less effective for severe cases).
• Use of a bone graft (for complex cases).
• Pros of the described procedure include direct correction and quicker recovery compared to non-surgical methods. Cons include surgical risks and possible complications.

Patient Experience

• The patient will feel groggy and sore post-surgery.
• Pain will be managed with medication.
• Discomfort and limited mobility are expected in the initial recovery period.
• Gradual improvement in arm strength and function with adherence to post-op care and physical therapy.