Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed
CPT4 code
Name of the Procedure:
Open Treatment of Fracture, Great Toe, Phalanx or Phalanges (Includes Internal Fixation)
Summary
This procedure involves surgically opening the great toe to treat a fractured bone in the phalanx or multiple phalanges. Internal devices like screws or plates are often used to fixate the bones and ensure proper healing.
Purpose
The procedure addresses the issue of broken bones in the great toe, which can result from trauma or accidents. The goal is to realign and stabilize the bones to aid in proper healing, alleviate pain, and restore the toe's function.
Indications
Symptoms or conditions that warrant the procedure include:
- A visibly deformed toe
- Severe pain unrelieved by conservative treatments
- Difficulty walking or bearing weight on the toe
X-ray confirmation of bone fracture(s) in the great toe
Patients appropriate for the procedure often include those with displaced fractures or non-healing fractures despite immobilization.
Preparation
Preparation for the procedure may include:
- Fasting for at least 8 hours before surgery
- Discontinuing certain medications as instructed by your doctor
- Undergoing pre-surgery diagnostic tests like X-rays or blood tests
Procedure Description
- Anesthesia: The patient is given either general anesthesia or a nerve block to numb the foot.
- Incision: A small incision is made over the fractured area.
- Realignment: The fractured bones are realigned manually.
- Internal Fixation: Screws, pins, or plates are placed internally to stabilize the bones.
- Closure: The incision is closed with stitches or surgical staples.
Equipment used includes surgical instruments for cutting and realigning bones, and internal fixation devices like screws or plates.
Duration
The procedure typically takes 1 to 2 hours.
Setting
The procedure is usually performed in a hospital or a surgical center.
Personnel
The healthcare team typically includes:
- An orthopedic surgeon
- An anesthesiologist or nurse anesthetist
- Surgical nurses and technicians
Risks and Complications
Common and rare risks include:
- Infection
- Bleeding
- Nerve or blood vessel damage
- Nonunion or delayed healing of the fracture
- Complications from anesthesia
Benefits
Expected benefits include:
- Stabilization and proper healing of the fractured bone
- Reduction in pain
- Restoration of toe function and mobility
- Benefits are typically realized over a period of weeks to months.
Recovery
Post-procedure care and instructions include:
- Keeping the foot elevated
- Wearing a protective boot or cast
- Avoiding weight-bearing activities
- Following up with physical therapy
- Expected recovery time is typically 6 to 8 weeks, depending on the severity of the fracture, with follow-up appointments as scheduled.
Alternatives
Other treatment options include:
- Non-surgical management like casting or splinting
- There might be slower recovery and a greater risk of the bones not healing properly.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel any pain. Post-surgery, patients may experience discomfort or pain that can be managed by prescribed pain medications. Swelling, bruising, and some level of immobility can be expected during the initial recovery phase.