Closed treatment of femoral fracture, proximal end, head; without manipulation
CPT4 code
Name of the Procedure:
Closed Treatment of Femoral Fracture, Proximal End, Head; without Manipulation
Common Name(s): Non-surgical femoral head fracture treatment
Summary
This procedure involves the non-surgical management of a break in the upper part of the thigh bone (femur) near the hip joint, specifically at the head of the femur, without physically adjusting the bone fragments.
Purpose
Addresses: Broken femur at the proximal (near hip) end.
Goals: To allow the femur to heal naturally in its current position without surgery, reduce pain, and restore hip function and mobility.
Indications
Symptoms or Conditions: Localized pain, swelling, or inability to bear weight on the affected leg.
Patient Criteria: Patients with non-displaced fractures where bone fragments are still aligned; suitable for those who may not tolerate surgery well.
Preparation
Pre-procedure Instructions: Follow provider’s guidelines which may include avoiding food/drink a few hours prior. Adjust or pause certain medications if instructed.
Diagnostic Tests: X-rays or MRI may be required to assess the fracture.
Procedure Description
- Initial Assessment: Pain management via over-the-counter painkillers or prescribed medications.
- Rest and Immobilization: The affected leg is immobilized using braces, splints, or casts.
- Monitoring and Follow-Up: Regular imaging (X-rays) to ensure the bone is healing properly.
Tools Used: Braces, splints, or casts.
Anesthesia/Sedation: Typically, none required as this is a non-invasive procedure.
Duration
The initial procedure is brief, usually under 30 minutes. Recovery and healing time spans several weeks to months.
Setting
Typically performed in an emergency room, outpatient clinic, or doctor's office.
Personnel
Involves healthcare professionals such as orthopedic surgeons, nurses, and radiologists.
Risks and Complications
Common Risks: Minor pain or discomfort from immobilization, muscle stiffness. Rare Risks: Non-union (failure of bone to heal), malunion (bone heals incorrectly), blood clots, or prolonged immobilization leading to muscle atrophy.
Benefits
Expected Benefits: Healing of the femoral fracture, pain reduction, and return of hip function. Timeline: Bone healing usually takes 6-12 weeks with proper immobilization and follow-up care.
Recovery
Post-procedure Care: Limit weight-bearing activities, follow-up appointments for monitoring, physical therapy may be recommended. Expected Recovery Time: Complete healing and recovery can take from several weeks up to a few months. Patients are typically advised to resume daily activities gradually.
Alternatives
Other Treatments: Surgical intervention (open reduction and internal fixation), physical therapy alone, or use of functional bracing. Pros and Cons: Surgery might offer quicker stabilization but involves higher risks and costs; physical therapy alone may not be adequate for severe fractures.
Patient Experience
During Procedure: Minimal discomfort expected as no invasive manipulation is involved. After Procedure: Possible mild discomfort from immobilization device, limited mobility initially. Pain managed through medications, with gradual improvement in comfort as the bone heals.