27230 Closed treatment of femoral fracture, proximal end, neck; without manipulation

Name of the Procedure:

Closed treatment of femoral fracture, proximal end, neck; without manipulation. Commonly referred to as "Non-surgical treatment of proximal femur fracture."

Summary

This procedure is used to treat a fracture in the neck of the femur (thigh bone) without the need for surgical intervention or manual bone manipulation. The treatment often includes immobilization and supportive care to allow the bone to heal naturally.

Purpose

The procedure addresses a fracture in the neck of the femur, which can occur due to trauma or falls, especially in older adults. The goal is to stabilize the fracture, reduce pain, and promote natural healing without surgery.

Indications

• Acute pain in the hip or groin region following an injury.
• Difficulty or inability to bear weight on the affected leg.
• X-ray or other imaging evidence confirming a neck of femur fracture.
• Patient conditions that make surgery high-risk or unnecessary for proper healing.

Preparation

• Patients might need to fast for several hours before the procedure if sedation is planned.
• Pre-procedure imaging tests like X-rays or MRIs to assess the extent of the fracture.
• Adjustments to medications, particularly blood thinners, as advised by the healthcare provider.

Procedure Description

1. Immobilization: The affected leg is immobilized using casting or splinting methods to ensure the bone remains stable during the healing process.
2. Supportive Care: Pain relief medications and possibly sedatives for comfort.
3. Monitoring: Regular follow-up X-rays to monitor the healing process.

Tools such as splints and casts are used, and general supportive care is provided. Sedation might be used for patient comfort.

Duration

The procedure to immobilize the fracture usually takes about 30 minutes. The overall healing process can take several weeks to months, monitored periodically.

Setting

Typically performed in a hospital or outpatient orthopedic clinic.

Personnel

• Orthopedic surgeon or physician
• Nursing staff
• Radiologic technologists for imaging assessments
• Anesthesiologist or sedation nurse if sedation is used

Risks and Complications

• Risk of non-union or delayed healing.
• Potential for misalignment of the fracture during healing.
• Risks associated with immobilization, such as deep vein thrombosis (DVT).
• Skin irritation or sores from casting materials.

Benefits

• Non-invasive with no surgical risks.
• Lower risk of infection compared to surgical methods.
• Enables natural healing of the bone.

Recovery

• Regular follow-up visits to monitor healing.
• Pain management with medications prescribed by the healthcare provider.
• Physical therapy may be required post-immobilization to regain mobility.
• Full recovery might take several months, with some restrictions on weight-bearing activities during this period.

Alternatives

• Surgical intervention (open reduction and internal fixation) if closed treatment is unsuitable.
• Use of orthopedic devices like hip pins or screws.
• Each alternative has its own risks and benefits that should be discussed with the healthcare provider.

Patient Experience

Patients may feel discomfort or pain before immobilization, which should gradually decrease with proper care and medication. Immobilized leg might feel stiff, and it is crucial to follow all instructions for movement and care to avoid complications. Pain management strategies, including medication and positioning, will be provided to ensure comfort throughout the recovery period.