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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

  1. Initial Assessment: The healthcare provider will assess the severity of the fracture and any associated injuries.
  2. Pain Management: Prescribe pain relievers (e.g., acetaminophen or ibuprofen) to manage discomfort.
  3. Immobilization: Application of a chest binder or wrap to stabilize the chest area and restrict movement.
  4. 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.

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