27222 Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction

Name of the Procedure:

Closed Treatment of Acetabulum (Hip Socket) Fracture(s); with Manipulation, with or without Skeletal Traction

Summary

In this procedure, a broken hip socket (acetabulum) is treated without making any incisions in the skin. The bones are manually adjusted back to their normal position by a physician, and sometimes special equipment known as skeletal traction is used to help maintain the correct alignment while the bone heals.

Purpose

This procedure is intended to fix fractures of the acetabulum, a critical part of the hip joint. The primary goals are to realign the bones to their natural position, promote proper healing, and restore functionality to the hip.

Indications

This procedure is typically recommended for patients with:

• Non-displaced or mildly displaced acetabular fractures
• Severe hip pain and swelling due to a fracture
• Difficulty in weight-bearing or walking
• Those who are unable or unsuitable candidates for open surgery

Preparation

• Fasting for a certain period before the procedure if anesthesia is planned
• Adjusting medications as per doctor’s instructions, especially blood thinners
• Pre-procedural imaging tests such as X-rays or CT scans to assess the fracture

Procedure Description

1. Anesthesia or sedation may be administered to keep the patient comfortable.
2. The patient is positioned appropriately to allow access to the hip area.
3. The surgeon manually manipulates the hip to realign the fractured bones. This may involve using traction to apply a pulling force along the leg.
4. Skeletal traction may involve inserting a pin or wire into the bone, connected to weights as needed to maintain proper alignment.
5. Post-manipulation, imaging is conducted to ensure the bones are properly aligned.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity of the fracture and the need for traction.

Setting

This procedure is usually performed in a hospital setting, often in an operating room or a specialized orthopedic treatment area.

Personnel

• Orthopedic surgeon
• Anesthesiologist (if general anesthesia is used)
• Nurses and surgical technicians

Risks and Complications

• Infection
• Bleeding or blood clots
• Nerve or blood vessel injury
• Hip joint stiffness or arthritis
• Malunion or non-union of the fracture, requiring further treatment

Benefits

• Reduced pain and quicker relief
• Proper alignment and stabilization of the hip joint
• Preservation of hip function and mobility
• Decreased need for more invasive surgery

Recovery

• Monitoring in a recovery area post-procedure
• Pain management with medications
• Instructions on limited weight-bearing activities
• Follow-up imaging to ensure proper healing
• Physical therapy may be needed to regain strength and mobility

Alternatives

• Open reduction and internal fixation (surgical option involving incisions and metal hardware)
• Non-surgical management with prolonged immobilization and physical therapy
• Each alternative has its own set of risks, benefits, and suitability based on the patient's condition.

Patient Experience

Patients may feel sore and experience some discomfort post-procedure, often managed with pain medications. Commonly, there will be some restrictions on movements and weight-bearing initially. Physical therapy and follow-up appointments will play a significant role in the overall recovery process.