25676 Open treatment of distal radioulnar dislocation, acute or chronic

Name of the Procedure:

Open Treatment of Distal Radioulnar Dislocation (Acute or Chronic)

Summary

In layman's terms, this surgical procedure involves correcting a dislocation in the wrist where the radius and ulna bones meet near the hand. It addresses both recent (acute) and long-standing (chronic) dislocations.

Purpose

This procedure aims to restore proper alignment and function of the wrist joint, alleviate pain, and prevent further joint damage for patients with dislocations of the distal radioulnar joint.

Indications

The surgery is indicated for individuals experiencing:

• Acute traumatic dislocation of the distal radioulnar joint.
• Chronic instability or repeated dislocations of the wrist.
• Persistent pain and functional impairment despite non-surgical treatments.

Preparation

Pre-procedure instructions include:

• Fasting for at least 8 hours prior to surgery.
• Discontinuation or adjustment of certain medications as instructed by the physician.
• Completing necessary diagnostic tests such as X-rays, MRI, or CT scans to assess the extent of the dislocation.

Procedure Description

1. Anesthesia: The procedure typically requires general anesthesia.
2. Incision: A surgical incision is made near the wrist to access the dislocated joint.
3. Reduction: The surgeon manipulates the bones to restore the joint alignment.
4. Stabilization: Pins, screws, or plates may be used to hold the bones in place.
5. Closure: The incision is closed with sutures or staples.

Duration

The surgery usually takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital or specialized surgical center.

Personnel

The surgical team includes:

• An orthopedic surgeon.
• An anesthesiologist.
• Surgical nurses and technicians.

Risks and Complications

Potential risks include:

• Infection.
• Nerve or blood vessel damage.
• Blood clots.
• Delayed bone healing or nonunion.
• Persistent pain or limited wrist motion. Complications are managed with medication, physical therapy, or additional surgery if needed.

Benefits

The procedure aims to:

• Relieve pain.
• Restore wrist function and stability.
• Prevent further joint injury. Benefits are generally realized within a few weeks to months post-surgery.

Recovery

Post-procedure care involves:

• Wearing a cast or splint to immobilize the joint.
• Pain management with prescribed medications.
• Physical therapy to regain strength and flexibility.
• Follow-up appointments to monitor healing. Expected recovery time is around 6 to 12 weeks, with activity restrictions as advised by the surgeon.

Alternatives

Alternative treatments may include:

• Non-surgical methods like splinting, casting, or physical therapy.
• Minimally invasive procedures like closed reduction. Pros and cons should be discussed with healthcare providers, as surgical correction is often required for chronic or severe cases.

Patient Experience

During the procedure, the patient will be under general anesthesia and won't feel anything. Post-surgery, discomfort and swelling are common, managed with pain relievers. Rehabilitation involves gradual return to normal activities, guided by healthcare professionals to ensure optimum recovery.