Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed
CPT4 code
Name of the Procedure:
Open Treatment of Distal Femoral Epiphyseal Separation (includes internal fixation)
Summary
This surgical procedure involves correcting a separation of the growth plate in the lower part of the femur (thighbone) near the knee. The surgeon will use internal fixation devices, such as screws or pins, to stabilize the bone and promote healing.
Purpose
The procedure addresses distal femoral epiphyseal separations, which can result from trauma or injury. The goal is to realign the bone properly, stabilize it, and ensure proper healing to maintain growth and function of the leg.
Indications
- Acute traumatic injury resulting in a growth plate separation
- Persistent pain and instability in the knee
- Displacement of the growth plate as confirmed by imaging studies
Preparation
- Patients should fast for 8-12 hours prior to the surgery.
- Medication adjustments may be necessary, particularly for blood thinners.
- Diagnostic tests such as X-rays or MRIs to assess the extent of the separation.
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made near the site of the injury.
- The surgeon carefully exposes the distal femur and the separated growth plate.
- The bone fragments are realigned to their proper position.
- Internal fixation devices such as screws or pins are inserted to stabilize the bone.
- The incision is closed with sutures or staples, and a sterile dressing is applied.
Duration
The procedure typically takes 1 to 2 hours.
Setting
The surgery is performed in a hospital operating room.
Personnel
- Orthopedic Surgeon
- Surgical Nurses
- Anesthesiologist
- Surgical Technologists
Risks and Complications
- Infection
- Bleeding
- Damage to surrounding tissues
- Improper bone healing or alignment
- Anesthesia-related complications
- Growth disturbances in the femur
Benefits
- Realignment and stabilization of the femur
- Reduced pain and improved function
- Prevention of long-term complications such as leg length discrepancies
Recovery
- Patients may need to stay in the hospital for observation for 1-2 days post-surgery.
- Pain management with prescribed medications.
- Limited weight-bearing on the affected leg, often necessitating crutches or a wheelchair.
- Physical therapy to regain strength and mobility.
- Follow-up appointments to monitor healing and remove stitches or staples.
- Typical recovery time is 8-12 weeks, depending on the patient's overall health and adherence to recovery protocols.
Alternatives
- Closed reduction and casting, if feasible
- External fixation devices, though they may not be as stable
- Non-surgical management, which may not provide adequate stabilization in severe cases.
Patient Experience
During the procedure, the patient will be under general anesthesia and unaware of the surgery. Post-operatively, the patient may experience pain and discomfort managed with medications. Swelling and bruising around the surgical site are common. Physical therapy will be necessary to regain full function of the leg. Pain and discomfort usually decrease significantly within the first few weeks, with full recovery expected over several months.