Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation
CPT4 code
Name of the Procedure:
Open Treatment of Ankle Dislocation (with or without percutaneous skeletal fixation; without repair or internal fixation)
Summary
This procedure involves surgically treating a dislocated ankle to realign the bones. It may involve using external pins or screws to temporarily stabilize the joint but does not include permanent internal fixtures.
Purpose
The procedure addresses the urgent and painful condition of an ankle dislocation where bones in the ankle joint are out of place. The goal is to realign the bones to restore function and mobility, reduce pain, and prevent long-term damage.
Indications
- Severe ankle injury with visible deformity and intense pain.
- Inability to move the ankle joint.
- Associated nerve or blood vessel damage.
- Failed attempt to correct the dislocation through non-surgical means.
Preparation
- Patients may need to fast for 6-8 hours before the procedure.
- Stop certain medications as advised, e.g., blood thinners.
- Preoperative diagnostic tests like X-rays or MRI to assess the extent of the dislocation.
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made over the dislocated ankle to expose the joint.
- The surgeon manually repositions the bones into their proper alignment.
- If needed, percutaneous skeletal fixation (pins or screws through the skin) is used to hold the alignment externally.
- The incision is closed with stitches or staples.
Duration
The procedure typically takes 1 to 2 hours.
Setting
This procedure is usually performed in a hospital operating room.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologist
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Nerve or blood vessel damage
- Re-dislocation
- Poor wound healing
Benefits
- Pain relief
- Restored alignment and stability of the ankle
- Improved mobility and function
- Reduced risk of long-term joint damage
Recovery
- Post-procedure, the patient may need to keep weight off the ankle, using crutches or a walker.
- Keep the incision area clean and dry.
- Pain management through prescribed medication.
- Physical therapy to regain strength and movement.
- Follow-up appointments to monitor healing.
Alternatives
- Non-surgical reduction methods (manual manipulation).
- Closed reduction with casting.
- Long-term bracing or immobilization.
- Each alternative carries its own risks and benefits and may be less effective in severe cases of dislocation.
Patient Experience
During the procedure, the patient won’t feel anything due to anesthesia. Post-procedure, they may experience pain controlled by medication, swelling, and bruising. Full recovery and return to normal activities can take several weeks to months, depending on the severity of the injury and adherence to rehabilitation protocols.