27215 Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring, includes internal fixation, when performed

Name of the Procedure:

Open Treatment of Iliac Spine(s), Tuberosity Avulsion, or Iliac Wing Fracture(s), Unilateral (for Pelvic Bone Fracture Patterns That Do Not Disrupt the Pelvic Ring), Including Internal Fixation (when performed)

Summary

This procedure involves surgically repairing a fracture of the iliac spine, tuberosity, or iliac wing on one side of the pelvis. It does not cover fractures that affect the stability of the pelvic ring. The surgical approach often includes the use of internal fixation devices such as screws and plates to stabilize the bone.

Purpose

The main goal of this procedure is to repair fractures of the pelvis that do not compromise the pelvic ring's integrity. This type of fracture is often a result of trauma like a fall or accident. The expected outcome is to restore the bone's normal alignment and function, allowing the patient to resume regular activities with reduced pain and risk of complications.

Indications

• Fracture of the iliac spine, tuberosity avulsion, or iliac wing
• Unstable bone fragments causing significant pain or functional impairment
• Non-displacement fractures that have not healed with conservative treatment
• Patient criteria typically include good overall health and the ability to undergo anesthesia

Preparation

• Patients may need to fast for 8-12 hours before the procedure.
• Regular medications may need adjustment, especially blood thinners.
• Preoperative assessments include X-rays, CT scans, and blood tests to evaluate the extent of the fracture and the patient's overall condition.

Procedure Description

1. Anesthesia: General anesthesia is usually administered to ensure the patient is unconscious and pain-free during the operation.
2. Incision: A surgical incision is made over the fracture site to expose the injured bone.
3. Reduction: The surgeon manipulates the bone fragments into their correct anatomical positions.
4. Internal Fixation: Plates, screws, or other fixation devices are used to secure the bones in the proper alignment.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes between 1 and 3 hours, depending on the complexity of the fracture.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurse
• Scrub Tech

Risks and Complications

• Infection
• Blood clots
• Damage to surrounding tissues or nerves
• Nonunion or delayed healing of the bone
• Reaction to anesthesia
• Implant failure or need for revision surgery

Benefits

• Stabilization of the fracture
• Pain relief
• Improved function and mobility
• Lower risk of complications associated with untreated fractures

Recovery

• Hospital stay of 1-3 days post-surgery
• Pain management with prescribed medications
• Physical therapy to regain strength and mobility
• Follow-up appointments to monitor healing
• Full recovery can take several months, with some restrictions on weight-bearing activities during the initial healing phase

Alternatives

• Non-surgical management including rest, immobilization, and physical therapy
• Percutaneous fixation (minimally invasive surgery)
• The choice of an alternative depends on the fracture's severity, patient’s overall health, and the potential for healing without surgery.

Patient Experience

Patients may experience pain and swelling at the surgical site, which can be managed with pain medications. Initial discomfort from the incision and internal fixation is normal. Physical therapy will be essential in regaining strength and function. Gradual improvement is expected, with full recovery taking several months.