Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint
CPT4 code
Name of the Procedure:
Open Treatment of Carpometacarpal Dislocation (Other than Thumb); Includes Internal Fixation, When Performed, Each Joint.
Summary
This surgical procedure involves the realignment and stabilization of dislocated carpometacarpal joints (excluding the thumb) using internal fixation techniques. The procedure ensures proper joint positioning and supports healing.
Purpose
The procedure addresses the dislocation of carpometacarpal joints, typically caused by trauma or injury. The primary goal is to restore joint function and stability, alleviate pain, and prevent long-term complications such as arthritis or reduced hand mobility.
Indications
- Severe pain and swelling in the hand or wrist.
- Visible deformity of the carpometacarpal joints.
- Inability to move or use the affected hand.
- Failure of non-surgical treatments to realign the joint.
Preparation
- Patients may need to fast for a certain period before the surgery.
- Adjustments to current medications as per the surgeon's advice.
- Pre-operative diagnostic tests, including X-rays or MRI, to assess the extent of the dislocation.
Procedure Description
- Anesthesia: The patient is administered general or regional anesthesia.
- Incision: A surgical incision is made over the affected carpometacarpal joint.
- Realignment: The surgeon assesses and realigns the dislocated joint.
- Internal Fixation: Plates, screws, or wires are used to stabilize the joint internally.
- Closure: The incision is closed with sutures, and a sterile dressing is applied.
Duration
The procedure typically takes about 1 to 2 hours, depending on the severity of the dislocation and the number of joints involved.
Setting
The procedure is performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic surgeon.
- Surgical nurses.
- Anesthesiologist.
- Surgical technologist.
Risks and Complications
- Infection at the surgical site.
- Damage to surrounding nerves or blood vessels.
- Limited range of motion or stiffness.
- Chronic pain or arthritis.
- Risks associated with anesthesia.
Benefits
- Proper alignment and stabilization of the joint.
- Reduction in pain and swelling.
- Improved hand function and mobility.
- Decreased risk of future joint problems.
Recovery
- Post-operative care includes pain management, typically with prescription medications.
- The hand may be immobilized in a cast or splint for several weeks.
- Physical therapy may be recommended to restore strength and mobility.
- Full recovery can take several weeks to months, with regular follow-up appointments for monitoring.
Alternatives
- Non-surgical treatments such as splinting and physical therapy.
- Closed reduction with manipulation and casting.
- Each alternative varies in invasiveness and recovery time; the choice depends on the severity of the dislocation and patient-specific factors.
Patient Experience
During the procedure, the patient will be under anesthesia and should not experience pain. Post-operatively, there may be soreness and swelling managed by medications. Comfort measures include elevation of the hand and application of ice packs.