Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia
CPT4 code
Name of the Procedure:
Prophylactic Treatment (Nailing, Pinning, Plating, or Wiring) with or without Methylmethacrylate, Tibia
Summary
This surgical procedure involves stabilizing the tibia (shinbone) using metal rods, pins, plates, or wires, sometimes combined with a bone cement called methylmethacrylate, to prevent fractures or treat bone weakness.
Purpose
The procedure aims to address bone weakness or instability in the tibia to prevent fractures. It provides structural support, helping the bone to heal properly or preventing it from breaking.
Indications
The procedure is appropriate for patients with:
- Osteoporosis or other conditions causing bone weakness.
- Fracture risk due to metastasis or lesions in the tibia.
- Previous fractures or surgical interventions in the tibia requiring additional support.
- Genetic or acquired conditions leading to bone fragility.
Preparation
Patients may need to:
- Fast for several hours before the procedure.
- Adjust or temporarily stop certain medications, such as blood thinners.
- Undergo blood tests, X-rays, or CT scans for surgical planning.
- Discuss allergies and medical history with their surgical team.
Procedure Description
- The patient is given anesthesia (general or regional) depending on the complexity of the procedure.
- The surgeon makes an incision over the tibia.
- Depending on the chosen method, metal rods (nailing), pins, plates, or wires are inserted to stabilize the bone.
- Methylmethacrylate may be used to fill gaps and provide additional support.
- The incision is closed with sutures or staples, and a dressing is applied.
Duration
The procedure typically lasts between 1 to 2 hours, depending on the complexity and technique used.
Setting
The procedure is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection at the surgical site.
- Blood clots.
- Nerve or blood vessel damage.
- Allergic reaction to anesthesia or materials used.
- Non-union or delayed healing of the bone.
- Complications from methylmethacrylate, such as leakage or reaction.
Benefits
- Significant reduction in fracture risk.
- Improved stability and strength of the tibia.
- Enhanced mobility and function.
- Pain relief from structural support.
Recovery
- Initial hospitalization for monitoring, followed by discharge instructions.
- Pain management with prescribed medications.
- Physical therapy to regain strength and mobility.
- Follow-up appointments to monitor healing.
- Recovery period can range from several weeks to a few months depending on the individual case.
Alternatives
- Non-surgical management with medications and physical therapy.
- External bracing or casting.
- Other surgical techniques based on specific patient conditions.
- Each alternative has its advantages and drawbacks, which should be discussed with a healthcare provider.
Patient Experience
During the procedure, the patient will be under anesthesia and should feel no pain. Postoperatively, there may be discomfort and pain managed with medications. Patients might experience swelling and limited mobility initially but these improve with time and rehabilitation efforts.