Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur
CPT4 code
Name of the Procedure:
Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur.
Summary
In layman's terms, this procedure involves stopping the growth of the greater trochanter—a part of the upper thigh bone—to address problems related to uneven leg length or hip joint development. This is done using a surgical technique called epiphysiodesis or by placing staples.
Purpose
The procedure addresses issues such as limb length discrepancies and developmental hip problems. The goal is to ensure balanced growth of the femur, resulting in improved function and mobility of the leg and hip.
Indications
- Significant limb length discrepancy
- Developmental hip dysplasia
- Uneven growth of the femur
- Congenital or acquired conditions affecting leg length
Preparation
- Patient fasting for 6-8 hours before the procedure
- Discontinuation of certain medications as advised by the doctor
- Preoperative imaging tests like X-rays or MRI to assess the growth plates and bone structure
Procedure Description
- The patient is brought to the operating room and given general anesthesia.
- The surgeon makes a small incision near the hip where the greater trochanter is located.
- Using specialized instruments, the surgeon performs epiphysiodesis, which involves disrupting the growth plate to halt further growth.
- Alternatively, metal staples may be inserted across the growth plate to stop its function mechanically.
- The incision is closed with sutures or surgical staples, and a sterile dressing is applied.
Tools and Equipment:
- Surgical instruments for bone work
- General anesthesia equipment
Duration
The procedure typically takes about 1 to 2 hours.
Setting
The procedure is performed in a hospital surgical suite or a specialized surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Support staff
Risks and Complications
- Infection
- Blood clots
- Nerve or blood vessel damage
- Incomplete arrest of bone growth
- Potential leg length discrepancy
Benefits
- Improved leg length equality
- Better hip function and mobility
- Prevention of further complications related to uneven growth
Recovery
- Post-procedure, the patient will need to rest and avoid bearing full weight on the affected leg.
- Follow-up appointments for X-rays to monitor the success of the growth arrest
- Physical therapy may be recommended for rehabilitation
- Full recovery typically takes several weeks to months
Alternatives
- Limb lengthening surgery
- Physical orthotic devices like shoe lifts
- Growth modulation medications
Pros and Cons of Alternatives:
- Limb lengthening involves a longer recovery period and higher risk of complications.
- Orthotic devices may not completely address the underlying growth issue but are non-invasive.
Patient Experience
- During the procedure, the patient is under general anesthesia and will not experience pain.
- Postoperative pain can be managed with prescribed pain medications.
- Some discomfort and limited mobility are expected initially, but these will improve with time and rehabilitation.