28575 Closed treatment of talotarsal joint dislocation; requiring anesthesia

Name of the Procedure:

Closed Treatment of Talotarsal Joint Dislocation; Requiring Anesthesia

Summary

This procedure involves realigning a dislocated talotarsal joint in the ankle without making an incision. Anesthesia is administered to ensure the patient does not feel pain during the realignment process.

Purpose

The procedure addresses talotarsal joint dislocation, which can cause severe pain and immobility. The goal is to restore normal joint alignment, reduce pain, and improve function.

Indications

• Severe pain in the ankle
• Visible deformity or abnormal positioning of the foot
• Inability to bear weight on the affected foot
• Swelling and bruising around the ankle
• Traumatic injury leading to dislocation

Preparation

• Fasting for at least 6-8 hours before the procedure if general anesthesia is used.
• Adjusting or stopping certain medications as advised by the healthcare provider.
• Pre-procedure imaging tests like X-rays or MRI to assess the dislocation.

Procedure Description

1. The patient is taken to the procedure area and given anesthesia (general or regional).
2. The affected ankle is examined and prepared.
3. The surgeon manually manipulates the talotarsal joint to reposition it back to its normal alignment.
4. Imaging may be used during the procedure to confirm proper alignment.
5. The ankle may be immobilized using a splint or cast to maintain alignment during healing.

Duration

Typically, the procedure takes about 30 minutes to an hour.

Setting

The procedure is usually performed in a hospital's emergency room or an outpatient surgical center.

Personnel

• Orthopedic surgeon or specialist
• Anesthesiologist
• Nurses and possibly a radiologic technologist

Risks and Complications

• Infection
• Nerve or blood vessel damage
• Persistent pain or instability
• Recurrent dislocations
• Failure to achieve proper alignment

Benefits

• Relief from pain
• Restoration of normal joint function
• Improved mobility and ability to bear weight on the foot
• Faster recovery compared to open surgical methods

Recovery

• The patient may need to wear a splint or cast for several weeks.
• Weight-bearing may be restricted initially; crutches might be needed.
• Follow-up appointments for monitoring and possible physical therapy.
• Full recovery time can range from 6 to 12 weeks.

Alternatives

• Open surgical reduction if the closed method is unsuccessful.
• Physical therapy for minor dislocations.
• Long-term use of braces or orthotics in case of chronic instability.

Patient Experience

• The patient will be under anesthesia and should not experience pain during the procedure.
• Post-procedure pain and discomfort can be managed with medication.
• Swelling and bruising are common but will subside over time.
• Early mobility might be limited, but gradual improvement is expected with adherence to recovery protocols.