28660 Closed treatment of interphalangeal joint dislocation; without anesthesia

Name of the Procedure:

Closed Treatment of Interphalangeal Joint Dislocation Without Anesthesia

Summary

This procedure involves manually realigning a dislocated finger or toe joint without the use of anesthesia. It is usually performed when a joint becomes displaced but can be put back into position through physical manipulation.

Purpose

The procedure aims to address the displacement of the interphalangeal joint, typically caused by trauma or injury. The goal is to restore normal joint alignment and function, alleviate pain, and prevent future complications.

Indications

• Visible deformity of the finger or toe.
• Inability to move the affected joint.
• Significant pain and swelling pointing to a dislocation.
• Patients who are medically stable and have no contraindications to the procedure.

Preparation

• Patients should inform the healthcare provider of all medications and underlying health conditions.
• No specific fasting or medication adjustments are typically required.
• An X-ray may be performed to confirm the dislocation and rule out fractures.

Procedure Description

1. The patient is positioned comfortably, often with the hand or foot elevated.
2. The healthcare provider will manually manipulate the affected joint to move it back into its proper alignment.
3. Gentle but firm pressure is applied to guide the joint back into place.
4. The area is immobilized afterward using a splint or bandage to maintain proper alignment.

Duration

The procedure typically takes about 5 to 15 minutes.

Setting

Usually performed in an outpatient clinic, emergency room, or urgent care facility.

Personnel

• A physician or an orthopedic specialist performs the manipulation.
• A nurse or medical assistant may assist.

Risks and Complications

• Pain or discomfort during the procedure.
• Potential damage to surrounding ligaments, tendons, or nerves.
• Rare risk of recurrence or instability of the joint.
• Possible need for surgery if the joint cannot be realigned manually.

Benefits

• Immediate relief from pain caused by the dislocation.
• Restoration of normal joint alignment and function.
• Quick and minimally invasive.

Recovery

• Patients are often advised to rest and avoid using the affected limb for a few days.
• Ice packs and over-the-counter pain medication may help manage pain and swelling.
• Follow-up appointments to monitor healing and ensure proper joint function.
• Physical therapy may be recommended for more severe cases.

Alternatives

• Open reduction surgery for irreducible dislocations.
• Anesthesia-assisted closed reduction for extremely painful or complex dislocations.
• Conservative management such as splinting without manipulation if there is no significant impairment.

Patient Experience

• Patients may experience discomfort as the joint is manipulated back into place but typically feel immediate relief once the dislocation is corrected.
• Pain management includes ice, elevation, and possibly over-the-counter pain relief medications.
• Rehab or physical therapy might be required for optimal recovery.