28675 Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed

Name of the Procedure:

Open Treatment of Interphalangeal Joint Dislocation (including internal fixation)

Summary

This procedure is a surgical intervention to correct a dislocated joint in the finger. It involves opening the joint area, realigning the dislocated bones, and securing them in place with internal fixation devices, such as screws or pins.

Purpose

The procedure addresses dislocations of the interphalangeal joints of the fingers. The goal is to restore proper alignment and function to the affected joint, relieve pain, and prevent future complications such as joint instability or arthritis.

Indications

• Severe pain and swelling in the finger joint
• Visible deformity of the finger
• Loss of finger function
• Unstable or recurrent joint dislocation This procedure is appropriate for patients who do not respond to non-surgical treatments or in cases where there is a high risk of joint instability.

Preparation

• Patients may need to fast for several hours prior to surgery.
• Adjustments to medications, particularly blood thinners, may be required.
• Pre-operative imaging studies like X-rays or MRIs will be conducted to assess the extent of the dislocation.

Procedure Description

1. The patient is given anesthesia, typically local or regional, to numb the area or general anesthesia in some cases.
2. An incision is made over the affected joint.
3. The dislocated bones are realigned to their normal position.
4. Internal fixation devices (e.g., screws, pins) are used to stabilize the joint.
5. The incision is closed with sutures, and a sterile bandage is applied. Tools used: scalpel, fixation devices (pins, screws), surgical clamps. Anesthesia: Local, regional, or general anesthesia, as required.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is usually performed in a hospital or surgical center, typically in an operating room setup.

Personnel

The procedure involves an orthopedic surgeon, surgical nurses, and possibly an anesthesiologist.

Risks and Complications

• Infection at the surgical site
• Bleeding
• Blood clots
• Nerve or blood vessel damage
• Joint stiffness
• Hardware-related problems (e.g., irritation, mechanical failure)

Benefits

The primary benefits include pain relief, restored alignment and function of the finger, and prevention of chronic issues like joint instability. Patients often begin to see improvements within a few weeks.

Recovery

• Post-procedure care includes wound care, pain management, and physical therapy.
• Patients may need to wear a splint or cast for several weeks.
• Follow-up appointments are necessary to monitor healing and remove any hardware.
• Full recovery typically ranges from a few weeks to several months, depending on the extent of the dislocation and the patient’s overall health.

Alternatives

• Non-surgical treatment (e.g., manual reduction, splinting)
• Closed reduction with external splinting Pros: Less invasive, shorter recovery time. Cons: Higher risk of recurrence and joint instability compared to open treatment.

Patient Experience

During the procedure, the patient might feel pressure but should not feel pain due to anesthesia. Post-procedure, there may be discomfort and swelling at the surgical site. Pain management includes prescribed pain medication. Physical therapy may be required to regain full finger function and mobility.