25530 Closed treatment of ulnar shaft fracture; without manipulation

Name of the Procedure:

Closed Treatment of Ulnar Shaft Fracture without Manipulation

Summary

Closed treatment of an ulnar shaft fracture without manipulation involves stabilizing the broken bone in the forearm without performing any realignment or surgery. This typically includes immobilization using a cast or splint to allow the bone to heal naturally.

Purpose

This procedure is used to treat fractures of the ulnar shaft, which is one of the bones in the forearm. The goal is to immobilize the bone to facilitate healing and prevent further injury. Achieving proper bone healing while maintaining arm function is crucial.

Indications

• Simple, non-displaced fractures of the ulnar shaft.
• Patients with good bone health and no need for surgical intervention.
• Limited movement of the broken bone and minimal pain.

Preparation

• Patients should follow their physician's instructions regarding pain management before the procedure.
• An X-ray or other imaging test will be performed to assess the fracture.
• No fasting or special preparation is typically required.

Procedure Description

1. Initial Assessment: The healthcare provider reviews imaging to confirm that manipulation is unnecessary.
2. Immobilization: A cast or splint is applied to the arm to stabilize the fracture. Care is taken to ensure that the immobilization device fits well and does not restrict circulation.
3. Instruction: The patient is given instructions on how to care for the cast or splint and how to monitor for potential issues like swelling or changes in sensation.

No anesthesia or sedation is needed as there is no manipulation of the bone.

Duration

The procedure itself typically takes about 30 minutes.

Setting

The procedure is generally performed in an outpatient clinic or emergency department.

Personnel

• Orthopedic specialists or emergency room physicians.
• Nurses or physician assistants for support and application of the cast or splint.

Risks and Complications

• Skin irritation or pressure sores from the immobilization device.
• Potential for the bone to heal improperly, leading to further treatment or surgery.
• Risk of stiffness or joint issues if immobilization is prolonged.

Benefits

• Non-invasive with minimal risk compared to surgical alternatives.
• Allows the bone to heal naturally with proper immobilization.
• Typically experiences less pain and quicker recovery times.

Recovery

• Follow-up visits to monitor the healing process and adjust the cast or splint if necessary.
• The average healing time is around 6-8 weeks, depending on the patient’s age and bone health.
• Physical therapy may be recommended after immobilization is removed to restore full function.

Alternatives

• Surgical intervention if the fracture is displaced or if complications arise.
• Open reduction and internal fixation (ORIF) as a surgical alternative.
• Pros: More immediate stabilization and alignment.
• Cons: Higher risk of complications, longer recovery time, and increased cost.

Patient Experience

• Mild to moderate discomfort from the cast or splint, which should be manageable with over-the-counter pain medications.
• Some limitations in daily activities due to immobilization, but most patients can resume normal activities gradually.
• Regular monitoring and follow-up are necessary to ensure proper healing and to address any concerns promptly.