Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or external fixation
CPT4 code
Name of the Procedure:
Open Treatment of Ankle Dislocation with Repair and Fixation
Summary
In this surgical procedure, a dislocated ankle joint is realigned through an incision, and the bones are stabilized using internal or external fixation devices. This may include screws, plates, or external frames to hold the bones in the correct position for proper healing.
Purpose
This surgery aims to treat ankle dislocations, restore the natural alignment of the bones, and stabilize the joint. The primary goal is to enable normal function and movement while preventing further injury or complications.
Indications
- Severe ankle dislocation not reducible by closed methods.
- Persistent instability of the ankle joint.
- Fractures associated with the dislocation.
- Inability to bear weight on the affected ankle.
Preparation
- Fasting for at least 8 hours before surgery.
- Adjusting medications as directed by the healthcare provider.
- Pre-operative imaging studies like X-rays or MRI.
- Blood tests and a complete medical evaluation.
Procedure Description
- The patient is administered general or regional anesthesia.
- An incision is made near the dislocated ankle.
- The bones of the ankle joint are realigned.
- Internal fixation devices (e.g., screws, plates) or an external fixation frame is used to hold the bones in place.
- Any torn ligaments or tissues may be repaired.
- The incision is closed with sutures or staples, and the ankle is bandaged.
Duration
Typically takes 1 to 3 hours, depending on the complexity of the dislocation and any associated fractures.
Setting
Performed in a hospital operating room or surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologists
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Damage to nerves or blood vessels
- Stiffness or decreased range of motion
- Failure to properly heal, necessitating further surgery
Benefits
- Restoration of normal ankle alignment and function.
- Improved stability and ability to bear weight on the ankle.
- Reduced pain and discomfort.
- Prevention of further complications or deformities.
Recovery
- Immobilization of the ankle with a cast or splint.
- Pain management with medications.
- Physical therapy to regain strength and range of motion.
- Follow-up appointments for monitoring healing.
- Full recovery may take several months, with some restrictions on weight-bearing activities.
Alternatives
- Closed reduction and immobilization: a less invasive option, but not always effective for severe dislocations.
- Conservative management: may include rest, ice, compression, and elevation (RICE), but less suitable for severe cases.
- Each alternative has specific pros and cons, and the choice depends on the severity of the dislocation and overall patient health.
Patient Experience
During the procedure, the patient will be under anesthesia and won't feel pain. Postoperatively, there may be pain, swelling, and bruising, managed with pain relief measures. Physical therapy and rehabilitation will be a key part of the recovery to regain full function and strength in the ankle.