27788 Closed treatment of distal fibular fracture (lateral malleolus); with manipulation

Name of the Procedure:

Closed Treatment of Distal Fibular Fracture (Lateral Malleolus) with Manipulation

Summary

In this procedure, a healthcare professional realigns and stabilizes a broken distal fibula (the outer bone of the lower leg near the ankle) without making any surgical incisions. This is often done using external manipulation to correct the bone position.

Purpose

The procedure addresses fractures in the distal fibula, often resulting from ankle injuries. It aims to restore proper alignment and function of the ankle while promoting healing of the bone.

Indications

• Significant ankle pain and swelling
• X-ray confirmation of a distal fibular fracture
• Instability of the ankle joint
• Difficulty bearing weight on the affected leg

Preparation

• The patient may need to fast for a few hours before the procedure if sedation is required.
• Inform the healthcare provider of all medications being taken; some may need to be adjusted.
• Diagnostic imaging like X-rays will be required to assess the fracture.

Procedure Description

1. The patient is positioned comfortably, and the affected leg is exposed.
2. Local anesthesia or sedation is administered to ensure comfort.
3. The healthcare professional manually manipulates the fractured bone segments to realign them properly.
4. Once alignment is achieved, a splint or cast is applied to maintain the position during healing.
5. Follow-up X-rays may be taken to confirm the successful realignment.

Duration

The procedure typically takes 30 minutes to an hour, depending on the complexity of the fracture.

Setting

The procedure is usually performed in an outpatient clinic, emergency room, or surgical center.

Personnel

• Orthopedic surgeon or emergency physician
• Nurses to assist with the procedure and sedation
• Radiology technician for imaging support

Risks and Complications

• Pain or discomfort during manipulation
• Re-displacement of the fracture
• Nerve or blood vessel damage
• Infection at the fracture site (rare)
• Delayed bone healing or non-union

Benefits

• Proper alignment of the bone to promote efficient healing
• Restoration of ankle function
• Avoidance of surgical intervention, reducing recovery time and risk

Recovery

• Keep the splint or cast dry and clean.
• Elevate the leg as much as possible to reduce swelling.
• Use crutches or other mobility aids as instructed.
• Follow-up visits and X-rays to monitor healing.
• Physical therapy may be required after the cast is removed.

Alternatives

• Open surgical treatment with internal fixation if the fracture is unstable or cannot be aligned non-surgically.
• Conservative treatment without manipulation, which may result in prolonged healing or poor alignment.

Patient Experience

The patient may feel pressure or discomfort during manipulation, managed with anesthesia or sedation. After the procedure, some pain and swelling are expected and can be controlled with pain medications and proper leg elevation.