28400 Closed treatment of calcaneal fracture; without manipulation

Name of the Procedure:

Closed Treatment of Calcaneal Fracture Without Manipulation

Summary

Closed treatment of a calcaneal fracture without manipulation involves stabilizing a broken heel bone without the need to physically adjust or align the bone fragments. The treatment is conservative and uses external support such as a cast or a splint.

Purpose

This procedure addresses fractures of the calcaneus (heel bone) that do not require realignment. The goals are to reduce pain, promote healing, and restore function to the foot without invasive methods.

Indications

• Acute pain and swelling in the heel following trauma
• Inability to bear weight on the affected foot
• Confirmation of a calcaneal fracture via X-ray
• Situations where bone fragments are already in a satisfactory position

Preparation

• No specific fasting or medication adjustments are typically required.
• Diagnostic imaging (X-rays or CT scans) to confirm the fracture and its alignment.

Procedure Description

1. The foot is examined to ensure the bone fragments are properly aligned.
2. A cast, splint, or boot is applied to immobilize the foot and allow the bone to heal naturally.
3. Crutches or a walker may be provided to help keep weight off the heel.
4. No anesthesia or sedation is generally needed as there is no manipulation of the bone.

Duration

The application of the cast or splint typically takes 30-60 minutes.

Setting

This procedure is performed in an outpatient clinic or an emergency department.

Personnel

• Orthopedic surgeon or physician
• Nurse or medical assistant

Risks and Complications

• Minor risks include skin irritation, pressure sores, or stiffness
• Rare risks include improper healing or need for surgical intervention if the fracture does not heal correctly

Benefits

• Non-invasive and less risky compared to surgical options
• Promotes natural healing of the bone
• Allows for earlier mobilization and reduced pain

Recovery

• Follow-up appointments for X-rays to monitor healing
• Instructions to keep the cast or splint dry and clean
• Typically 6-8 weeks of immobilization followed by physical therapy
• Restricted weight-bearing initially, gradually increasing as healing progresses

Alternatives

• Open reduction and internal fixation (surgical option)
• Manipulation and closed reduction for more severe fractures
• Pros include precise alignment and faster recovery; cons include higher risks and longer initial immobilization

Patient Experience

• Initial discomfort from swelling, which decreases with proper elevation and ice application
• Temporary limitation in mobility, managed with crutches or walkers
• Pain management through over-the-counter pain relievers or prescribed medication