Application of halo, including removal; femoral
CPT4 code
Name of the Procedure:
Application of Halo, Including Removal; Femoral. Commonly known as the halo procedure or halo traction.
Summary
This procedure involves attaching a halo device to the femoral region to stabilize or correct the position of bones. The halo is a metal ring fixed to the bones with pins, and it's used to apply traction or immobilize the area.
Purpose
The procedure aims to treat fractures, deformities, or other orthopedic conditions of the femur requiring precise stabilization. It helps in aligning bones properly and facilitating optimal healing.
Indications
- Severe femoral fractures
- Congenital deformities
- Bone tumors requiring stabilization
- Post-surgical recovery that necessitates rigid immobilization
Preparation
- Fasting for several hours if general anesthesia is planned
- Adjustment of current medications, especially blood thinners
- Preoperative imaging, such as X-rays or MRIs, to assess the femoral condition
- Blood tests to check for any contraindications
Procedure Description
- Preparation: Administration of anesthesia (general or local) as required.
- Attachment: The halo ring is carefully positioned around the femoral area.
- Fixation: Pins are inserted through the skin into the bone to secure the halo.
- Traction or Immobilization: The halo device is adjusted to maintain proper bone alignment.
- Removal: Once the bone has healed adequately, the halo and pins are removed in a subsequent procedure.
Tools include a halo ring, fixation pins, and traction apparatus. Depending on the needs, anesthesia may range from local to general.
Duration
The initial application typically takes 1 to 2 hours. Healing and wearing the device can last anywhere from several weeks to months, depending on the individual case.
Setting
This procedure is performed in a hospital or a specialized surgical center under sterile conditions.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Radiology technician (for intraoperative imaging)
Risks and Complications
- Infection at the pin sites
- Pin loosening or migration
- Nerve or blood vessel damage
- Pain or discomfort during and after the procedure
- Complications related to anesthesia
- Rarely, improper bone healing or alignment issues
Benefits
- Effective stabilization and alignment of femoral bones
- Reduced risk of further deformity or injury
- Promotes optimal healing conditions for the bone
- Typically noticeable improvements in mobility and pain within a few weeks post-recovery
Recovery
- Pain management with prescribed medications
- Regular cleaning of pin sites to prevent infection
- Physical therapy to regain mobility and strength
- Activity restrictions, such as avoiding weight-bearing on the affected leg
- Follow-up appointments for progress monitoring and eventual halo removal
Alternatives
- Internal fixation with metal rods or plates
- External fixation without a halo device
- Non-surgical treatments like casting or bracing
- Each alternative offers different benefits and risks depending on the patient's specific condition, overall health, and preferences.
Patient Experience
During the procedure, under anesthesia, the patient should feel no pain. Post-procedure, some discomfort is typical but manageable with pain relief measures. They may feel constrained due to the device, but over time, most patients adapt until the halo is removed.
Pain management, counseling, and patient education are vital for comfort and compliance throughout the recovery process.