25675 Closed treatment of distal radioulnar dislocation with manipulation

Name of the Procedure:

Closed treatment of distal radioulnar dislocation with manipulation

Summary

This procedure involves manually realigning the bones of the wrist that have been dislocated. It is performed without surgical incisions and aims to restore proper joint alignment to enable normal wrist function.

Purpose

The procedure addresses the dislocation of the distal radioulnar joint, which can cause pain, swelling, and impaired wrist movement. The goal is to reposition the bones, relieve symptoms, and restore wrist function.

Indications

• Visible deformity or swelling at the wrist
• Inability to move the wrist or forearm
• Severe pain localized at the distal radioulnar joint
• X-ray confirmation of distal radioulnar dislocation

Preparation

• The patient may need to fast for several hours if sedation is required.
• Discontinue certain medications as advised by the physician.
• Diagnostic imaging (X-ray, MRI) may be conducted to confirm the dislocation.

Procedure Description

1. The patient is positioned comfortably, and sedation or local anesthesia is administered.
2. The healthcare provider applies specific manual pressure to reposition the dislocated bones.
3. Post-manipulation X-rays are taken to ensure proper alignment.
4. The wrist may be immobilized with a splint or cast to maintain alignment during healing.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity of the dislocation.

Setting

This procedure is generally performed in an emergency room or outpatient clinic.

Personnel

• Orthopedic surgeon or emergency physician
• Radiologist for imaging support
• Nurses or medical assistants

Risks and Complications

• Pain or discomfort during manipulation
• Recurrence of dislocation
• Nerve or blood vessel injury
• Incomplete reduction requiring surgical intervention
• Potential for arthritis development in the joint

Benefits

• Relief from pain and swelling
• Restoration of normal wrist function
• Avoidance of invasive surgical procedures
• Quick recovery and return to daily activities

Recovery

• Immobilization in a cast or splint for several weeks
• Instructions for pain management and activity restrictions
• Follow-up appointments to monitor healing and joint stability
• Possible physical therapy to restore full function

Alternatives

• Surgical treatment for complex or recurrent dislocations
  • Pros: Potentially more stable reduction
  • Cons: Higher risk, longer recovery
• Conservative management (e.g., rest, immobilization without manipulation)
  • Pros: Non-invasive
  • Cons: May not correct dislocation, prolonged symptoms

Patient Experience

Patients may experience some pain during and shortly after the procedure, which can be managed with pain medications. They should expect limited wrist movement during the immobilization period and may need physical therapy to regain full range of motion and strength.