Closed treatment of sternum fracture
CPT4 code
Name of the Procedure:
Closed Treatment of Sternum Fracture (Non-Surgical Management of Sternal Fracture)
Summary
In this procedure, a broken sternum (or breastbone) is managed without surgery. The treatment focuses on allowing the bone to heal naturally, typically using immobilization and pain management techniques.
Purpose
The closed treatment of a sternum fracture aims to help the breastbone heal correctly without requiring invasive surgery. This method addresses the pain, prevents further injury, and ensures proper bone healing.
Indications
- Trauma to the chest, resulting in a broken sternum
- Pain and tenderness in the chest area
- Difficulty breathing or chest discomfort
- Patients are typically stable without signs of significant internal organ damage or other complications
Preparation
- Avoid certain activities that could worsen the injury.
- Diagnostic tests, such as X-rays or CT scans, to confirm the fracture and assess its severity.
- No specific fasting or medication adjustments unless indicated by the healthcare provider.
Procedure Description
- Initial Assessment: The healthcare provider will assess the severity of the fracture and any associated injuries.
- Pain Management: Prescribe pain relievers (e.g., acetaminophen or ibuprofen) to manage discomfort.
- Immobilization: Application of a chest binder or wrap to stabilize the chest area and restrict movement.
Monitoring: Regular follow-up appointments to monitor the healing process via physical exams and imaging.
No surgical tools are used; the procedure principally involves careful physical examination and the use of wraps or binders. Anesthesia is not typically required.
Duration
The entire process from initial assessment to immobilization can take a few hours, but the healing process can last several weeks to months.
Setting
Typically performed in a hospital's emergency department or outpatient clinic.
Personnel
- Emergency or orthopedic physician
- Radiology technician (for imaging)
- Nurses for assistance and patient care instructions
Risks and Complications
- Inadequate immobilization leading to misalignment or improper healing
- Prolonged pain or discomfort
- Potential for secondary infections at injury site
- Rarely, complications like pneumothorax (collapsed lung) if the fracture is severe
Benefits
- Avoids surgical risks and complications
- Reduced recovery time compared to surgery
- Effective pain management and proper bone healing
Recovery
- Follow-up appointments for monitoring
- Restriction on strenuous activities to ensure proper healing
- Most patients can expect to resume normal activities within a few weeks, although full healing may take longer
Alternatives
- Surgical treatment in severe cases where bone fragments are displaced or if there are associated complications.
- Pros: Surgery can immediately correct severe misalignments.
- Cons: Higher risk of complications, longer recovery time, invasiveness.
Patient Experience
- Patients may experience discomfort and require pain management, especially in the initial weeks.
- Regular imaging follow-ups to monitor healing progress.
- Patients should expect to limit activities like heavy lifting or strenuous exercise during the recovery period. Pain is generally managed with over-the-counter or prescribed medication, and comfort measures such as chest wraps can help stabilize the area and reduce discomfort.