Repair of nonunion or malunion, humerus; without graft (eg, compression technique)
CPT4 code
Name of the Procedure:
Repair of nonunion or malunion, humerus; without graft (e.g., compression technique)
Common Names: Humerus fracture repair without graft, Compression fixation for humerus nonunion/malunion
Summary
This surgical procedure is designed to correct a humerus bone that has not healed properly after a fracture (nonunion) or has healed in an incorrect position (malunion), using techniques that do not involve bone grafts.
Purpose
The procedure addresses improperly healed fractures of the humerus. The goal is to enable proper healing, restore the normal anatomy and function of the arm, and alleviate pain or discomfort.
Indications
- Persistent pain at the fracture site.
- Impaired arm function due to improper bone healing.
- X-ray evidence of nonunion or malunion of the humerus.
- Failed previous fracture treatments.
Preparation
- Fasting typically required 8 hours before surgery.
- Adjustment or cessation of certain medications as advised by the doctor.
- Preoperative imaging studies such as X-rays or CT scans.
- Routine preoperative labs (blood tests, EKG, etc.).
Procedure Description
- Anesthesia: General anesthesia or regional block is administered.
- Incision: A surgical cut is made over the humerus to expose the affected area.
- Bone Realignment: The surgeon aligns the bone fragments correctly.
- Compression Technique: Metal implants (plates, screws) are used to compress the bone fragments together, enhancing stability and promoting healing.
- Closure: The incision is closed with sutures or staples.
Duration
The procedure typically takes around 2 to 3 hours.
Setting
Performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Surgical Technicians
Risks and Complications
- Infection at the surgical site.
- Bleeding or blood clots.
- Nerve or blood vessel damage.
- Implant failure.
- Delayed or impaired bone healing.
Benefits
- Improved alignment and healing of the humerus.
- Reduced pain and restored arm function.
- Increased likelihood of returning to daily activities and normal use of the arm.
Recovery
- Pain management with prescribed medications.
- Immobilization of the limb (slings or braces) initially.
- Physical therapy to restore strength and motion.
- Regular follow-up visits to monitor bone healing.
- Recovery time can range from several weeks to a few months depending on individual factors.
Alternatives
- Non-surgical treatments like physical therapy or immobilization (less effective for nonunion/malunion).
- Bone grafting techniques if suitable.
Electrical bone stimulation.
Pros of This Procedure: Direct correction of bone alignment without the need for grafts, shorter recovery time. Cons of Alternatives: Prolonged treatment period, less immediate correction of bone structure.
Patient Experience
- During the Procedure: Under anesthesia, so no pain will be felt.
- Post-Procedure: Initial soreness and discomfort managed with pain relief; gradual improvement with physical therapy.
- Pain Management: Prescription medications, ice, and rest as needed.