Closed treatment of radial and ulnar shaft fractures; without manipulation
CPT4 code
Name of the Procedure:
Closed Treatment of Radial and Ulnar Shaft Fractures; Without Manipulation
Summary
This procedure involves the non-surgical treatment of fractures in the shafts of the radial and ulnar bones in the forearm. No manual adjustment or repositioning of the bone fragments is performed.
Purpose
The procedure aims to allow natural healing of the broken or fractured radial and ulnar shafts without the need for surgical intervention. It stabilizes the fractures to promote bone healing.
Indications
- Simple fractures of the radial and ulnar shafts.
- Pain, swelling, and inability to move the affected arm.
- Suitable for patients with fractures that have not displaced significantly.
Preparation
- No specific fasting required.
- Avoid eating or drinking if instructed, based on the presence of other medical conditions.
- Diagnostic imaging such as X-rays to confirm the fracture type and location.
- Review of medical history and any medications.
Procedure Description
- The affected arm is usually immobilized using a cast or splint.
- The arm is positioned in a manner to support proper alignment.
- No attempts are made to manually adjust the bone fragments.
Regular follow-up X-rays to monitor the healing process.
Tools and Equipment:
- Cast material (plaster or fiberglass)
- Splinting material
- X-ray machine
Anesthesia/Sedation:
- Typically not required as no manipulation is involved.
Duration
The initial procedure takes roughly 30 minutes. Casting may take about 15-20 minutes.
Setting
- Hospital outpatient department
- Specialized orthopedic clinic
Personnel
- Orthopedic surgeon or physician
- Radiologic technologist for X-rays
- Nursing staff for assistance
Risks and Complications
- Skin irritation from the cast
- Muscle stiffness
- Delayed union or nonunion of the fractures
- Potential for improper healing if not monitored closely
Benefits
- Non-invasive and avoids surgical risks
- Encourages natural healing
- Quick initial treatment; casts promote bone stability
Recovery
- Regular follow-up appointments for X-rays to assess healing.
- Cast care instructions to prevent complications.
- Restricted arm use until the bone is fully healed.
- Typical healing time ranges from 6 to 12 weeks.
Alternatives
- Open reduction and internal fixation (surgical approach)
- External fixation
- Pros: Precision in bone alignment with surgery.
- Cons: Increased risk of infection and longer recovery post-surgery.
Patient Experience
- Patients may feel discomfort from the arm cast.
- Pain management with over-the-counter pain relievers.
- Encouraged to elevate the arm and apply ice to reduce swelling.
- Initial limitation in arm movement and functionality.
- Support from healthcare providers to ensure comfort and proper healing.