20690 Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system

Name of the Procedure:

Application of a Uniplane (Pins or Wires in 1 Plane), Unilateral, External Fixation System

Summary

The application of a uniplane unilateral external fixation system involves placing pins or wires into the bone and securing them with an external frame. This device stabilizes the bone to allow for proper healing, typically used for fractures or deformities.

Purpose

The procedure addresses bone fractures or deformities that require stabilization for proper healing. The primary goal is to maintain bone alignment, stabilize the fracture, and allow for early mobility and weight-bearing.

Indications

• Severe fractures
• Bone deformities
• Bone infections
• Post-surgical stabilization
• Conditions requiring stable bone alignment

Preparation

• Fasting for at least 8 hours if general anesthesia is used
• Adjustment of medications as directed by the physician
• Blood tests, X-rays, or MRI to assess the affected area

Procedure Description

1. Anesthesia is administered (local, regional, or general).
2. The surgeon makes small incisions near the fracture.
3. Metal pins or wires are inserted into the bone on one side of the fracture.
4. An external frame is attached to these pins or wires to hold the bone in alignment.
5. The frame is adjusted to ensure correct positioning of the bone.
6. The incisions are closed, and the external fixator is left in place to stabilize the bone.

Duration

The procedure typically takes 1 to 2 hours.

Setting

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

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection at the pin or wire sites
• Nerve or blood vessel damage
• Mechanical failure of the fixation device
• Malalignment or nonunion of the fracture
• Pain or discomfort from the external frame

Benefits

• Stabilizes fractures and deformities, allowing for proper healing
• Promotes early mobility and weight-bearing
• Can be adjusted externally as needed

Recovery

• Regular cleaning of the pin/wire sites to prevent infection
• Follow-up appointments for adjustments and monitoring
• Activity restrictions as prescribed by the physician
• Physical therapy may be recommended to regain strength and mobility
• Recovery time varies but generally takes several weeks to months

Alternatives

• Internal fixation (e.g., plates, screws)
• Casting or splinting
• Traction
• Each alternative has its own pros and cons, such as the increased invasiveness of internal fixation or less stability with cast immobilization.

Patient Experience

• The patient may feel some discomfort or pain during the procedure, which is managed with anesthesia.
• Post-procedure, there may be pain at the pin/wire sites, managed with pain medications and proper care.
• It may take time to adjust to the external frame, but it is designed to allow for mobility and improved healing.