27193 Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; without manipulation

Name of the Procedure:

Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; without manipulation

Summary

This procedure involves treating fractures, dislocations, and separations of the pelvic bones without physically adjusting the bones through surgery. It aims to allow the pelvic bones to heal naturally with the help of supportive measures like rest and pain management.

Purpose

The purpose of this procedure is to address injuries to the pelvic bone structure, specifically those that do not require manual manipulation or surgical intervention. The goal is to reduce pain, support natural healing, and prevent further injury or complications.

Indications

• Pelvic fractures that are stable and do not require surgical correction
• Mild dislocations or separations (diastasis) of the pelvic bones
• Subluxations where the bones are partially misaligned but still relatively stable
• Patients who are not suitable candidates for surgical intervention due to other health conditions

Preparation

• The patient may need diagnostic imaging tests such as X-rays or CT scans to assess the extent of the injury.
• Fasting is generally not required unless sedation is deemed necessary for pain management.
• Patients should inform the medical team about any medications they are taking, as some may need adjustment.

Procedure Description

1. The patient is evaluated and pain management strategies are discussed.
2. Supportive devices, like pelvic binders, may be applied to stabilize the area.
3. The patient is advised on rest and limited movement to allow natural healing.
4. Pain medications and possibly anti-inflammatory drugs are prescribed.
5. Routine monitoring and follow-up appointments are scheduled to ensure proper healing.

Duration

The initial procedure typically takes about 30 minutes to an hour, primarily involving evaluation and stabilization. Follow-up care will vary depending on the healing process.

Setting

This procedure is usually performed in a hospital emergency department, outpatient clinic, or doctor's office.

Personnel

• Orthopedic surgeon or trauma specialist
• Nurses
• Radiologists (for imaging diagnostics)
• Pain management specialists, if needed

Risks and Complications

• Risks include improper healing of the fracture, chronic pain, or instability of the pelvic ring.
• Rare complications might involve infection, blood clots, or pressure sores from immobilization devices.
• Management typically involves physical therapy, additional imaging, or in severe cases, surgical intervention.

Benefits

• Non-invasive treatment reducing the risk of surgical complications.
• Promotes natural healing of the pelvic bones.
• Pain relief and stabilization can be quickly achieved.

Recovery

• Patients may need to limit physical activity for several weeks to months.
• Follow-up imaging and medical appointments are required to monitor healing progress.
• Physical therapy may be necessary to regain strength and mobility.

Alternatives

• Open reduction and internal fixation (surgical intervention) for more severe fractures or instability.
• External fixation using frames or pins to stabilize the bones from outside the body.
• Pros and cons vary with each alternative, including the invasiveness of surgery and potential for faster recovery with surgical options.

Patient Experience

• Patients will likely experience pain and discomfort; effective pain management will be a priority.
• Support and guidance will be provided by the medical team to ensure a comfortable recovery.
• Communication with healthcare providers is crucial for addressing any concerns or complications promptly.