27248 Open treatment of greater trochanteric fracture, includes internal fixation, when performed

Name of the Procedure:

Open Treatment of Greater Trochanteric Fracture (includes internal fixation when performed)

Summary

The open treatment of a greater trochanteric fracture involves surgically repairing a broken part of the upper thigh bone near the hip. The procedure typically includes internal fixation, where specialized equipment like screws or plates is used to hold the bone fragments in place to ensure proper healing.

Purpose

This procedure addresses fractures of the greater trochanter, a critical area of the hip bone that can get fractured due to trauma. The main goal is to stabilize the bone, reduce pain, and restore the patient's mobility and function as quickly as possible.

Indications

• Severe pain in the hip area following a fall or accident
• Difficulty walking or inability to bear weight on the affected leg
• X-ray or imaging confirmation of a greater trochanteric fracture
• Failed conservative treatment approaches (e.g., rest, physical therapy)

Preparation

• Fasting for at least 6-8 hours prior to the procedure
• Discontinuing certain medications, especially blood thinners, as advised by the doctor
• Undergoing pre-operative evaluations, such as blood tests, ECG, or imaging studies (X-rays, MRI)

Procedure Description

1. Anesthesia: The patient is given general anesthesia or regional anesthesia (spinal or epidural).
2. Incision: An incision is made over the affected hip area.
3. Exposure: The surgeon exposes the fractured bone.
4. Fixation: Internal fixation devices, like plates and screws, are used to stabilize the bone fragments.
5. Closure: The incision is closed with sutures or staples, and a dressing is applied.

Specialized orthopedic tools and imaging techniques (e.g., fluoroscopy) are often used to ensure accurate placement of the fixation devices.

Duration

The procedure typically takes around 1-2 hours, depending on the complexity of the fracture.

Setting

The procedure is usually performed in a hospital operating room or a dedicated surgical center.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurses and Technicians
• Radiologic Technologist (for imaging during surgery)

Risks and Complications

• Infection at the surgical site
• Blood clots (deep vein thrombosis)
• Nerve or blood vessel damage
• Non-union or delayed union of the fracture
• Risks related to anesthesia
• Possible need for additional surgeries

Benefits

• Reduction of pain and improvement in mobility
• Enhanced bone healing and recovery
• Reduced risk of complications associated with untreated fractures (e.g., chronic pain, immobility)

Recovery

• Post-procedure, patients may need to stay in the hospital for a few days.
• Physical therapy begins shortly after surgery to enhance recovery.
• Instructions may include weight-bearing restrictions, wound care, and medications for pain management.
• Full recovery may take several weeks to months, depending on the individual's health and adherence to rehabilitation protocols.

Alternatives

• Conservative treatments like rest, physical therapy, and pain management are options but are generally less effective for significant fractures.
• Non-surgical traction or temporary bracing might be used but usually offer limited stability.

Patient Experience

• During the procedure: Patients will be under anesthesia and should not feel pain.
• After the procedure: Initial pain at the surgical site managed with medications; some discomfort during the healing process is normal.
• Physical therapy plays a vital role in restoring function, and adherence to rehabilitation exercises is crucial for optimal recovery.
• Regular follow-up appointments will monitor the progress and ensure proper healing.

Pain management and comfort measures are integrated throughout the patient’s recovery journey to ensure they regain their mobility and quality of life.