28515 Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each

Name of the Procedure:

Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each. Commonly referred to as "non-surgical fracture reduction of toe bones (excluding the big toe) with manipulation."

Summary

In simple terms, this procedure involves realigning broken bones in the toes, excluding the big toe, without making an incision. The doctor uses their hands to manipulate the bones back into place.

Purpose

Medical Condition:

• Treats broken toe bones (excluding the big toe).

Goals:

• Properly align fractured bones to ensure they heal correctly.
• Restore normal function and appearance of the toe.
• Reduce pain and improve mobility.

Indications

Symptoms and Conditions:

• Acute pain following trauma.
• Swelling, bruising, or deformity in the toes.
• Inability to move the affected toe or bear weight on the foot.

Patient Criteria:

• Suitable for patients with simple, displaced fractures of the toe bones.

Preparation

Instructions:

• Generally, no fasting is required.
• Inform the doctor of any medications or health conditions.
• Follow specific instructions provided by the healthcare provider.

Diagnostic Tests:

• X-rays to confirm the fracture and assess its severity.

Procedure Description

1. The patient is positioned comfortably, usually lying down.
2. Local anesthesia or a nerve block is administered to numb the affected toe.
3. The doctor uses hands to gently manipulate and align the fractured bone fragments.
4. Once aligned, the toe is immobilized using a splint, buddy taping, or a special shoe.

Tools and Equipment:

• X-ray machine, splints, adhesive tape, special footwear.

Anesthesia:

• Local anesthesia or nerve block to numb the area.

Duration

Typically, the procedure takes about 20 to 30 minutes.

Setting

Performed in a hospital emergency room, outpatient clinic, or urgent care center.

Personnel

• Orthopedic surgeon or a trained physician.
• Nurses or medical assistants to assist with preparation and post-procedure care.

Risks and Complications

Common Risks:

• Swelling and bruising.
• Pain at the fracture site.

Rare Risks:

• Infection.
• Nerve or blood vessel damage.
• Nonunion (failure of the bone to heal properly).
• Malunion (healing in an incorrect position).

Benefits

• Reduced pain and improved toe function.
• Facilitates proper bone healing.
• Quick, minimally invasive procedure with minimal recovery time.

Recovery

Post-Procedure Care:

• Keep the toe immobilized as instructed.
• Elevate the foot to reduce swelling.
• Apply ice packs if recommended.
• Take prescribed pain medications.

Recovery Time:

• Typically, a few weeks to a few months, depending on the severity of the fracture.

Restrictions:

• Avoid putting weight on the affected toe until cleared by the doctor.
• Follow-up appointments for X-rays and monitoring the healing process.

Alternatives

Other Treatment Options:

• Surgical intervention for complex fractures.
• Conservative treatments like buddy taping for non-displaced fractures.

Pros and Cons:

• Surgery may provide better results for complex injuries but involves more risks and longer recovery.
• Conservative treatments are less invasive but may not be suitable for displaced fractures.

Patient Experience

During the procedure, the patient will feel little to no pain due to local anesthesia. There might be some discomfort from the manipulation. After the procedure, there may be mild pain, managed with medications. Following post-care instructions will help in a smooth recovery.