Name of the Procedure:

Closed Treatment of Supracondylar or Transcondylar Humeral Fracture, with or without Intercondylar Extension; Without Manipulation
Common name(s): Non-surgical fracture treatment, Closed reduction of humerus fracture.

Summary

This procedure involves the non-surgical treatment of a fracture in the lower part of the upper arm bone (humerus) near the elbow. No bone manipulation is performed, and non-invasive methods such as casting or splinting are used to stabilize the bone.

Purpose

The primary goal is to allow the fractured humerus to heal properly without surgical intervention. This treatment helps to stabilize the bone, reduce pain, and restore function to the arm.

Indications

• Fractures of the distal humerus (supracondylar or transcondylar) that are stable and do not require surgical alignment.
• Suitable for patients with minimal displacement or those for whom surgery presents higher risks.
• Used when the fracture does not involve significant damage to surrounding tissues or major blood vessels.

Preparation

• Patients may be advised to avoid eating or drinking for a few hours before the procedure if sedation is needed.
• Diagnostic imaging like X-rays or MRIs will be required to assess the fracture.
• The patient should inform the healthcare team about any medications or allergies.

Procedure Description

1. Initial Assessment: The healthcare provider reviews imaging results and physically examines the fractured area.
2. Immobilization: A cast or splint is carefully applied to immobilize the fractured humerus and maintain alignment.
3. Pain Management: Over-the-counter pain relievers or specific medications might be prescribed.
4. Monitoring: Periodic imaging may be conducted to ensure proper healing.

Tools and Equipment:

• Cast materials (plaster or fiberglass)
• Splints
• Bandages and padding
• Diagnostic imaging devices (X-ray machines)

Anesthesia or Sedation:

• Typically, no general anesthesia is required. In some cases, local anesthesia or light sedation may be used for patient comfort.

Duration

The initial application of the cast or splint typically takes about 30 minutes to an hour. Follow-up appointments will be scheduled to monitor healing.

Setting

The procedure is generally performed in an outpatient clinic or an emergency room setting.

Personnel

• Orthopedic doctor or a trained healthcare provider
• Nurses or medical assistants
• Radiologic technicians for imaging

Risks and Complications

Common Risks:

• Discomfort or tightness from the cast/splint.
• Minor skin irritation.

Rare Complications:

• Compartment syndrome if swelling is extensive.
• Improper healing or misalignment requiring further intervention.
• Nerve damage or circulatory issues if the cast is too tight.

Benefits

• Non-invasive, avoiding the risks associated with surgery.
• Allows the bone to heal naturally.

• Preserves the range of motion and function in the majority of cases.

  Expected benefits might be realized within weeks to months as the bone heals.

Recovery

• Post-procedure care: Keep the cast or splint dry and clean. Elevate the arm to reduce swelling.
• Follow-up: Regular follow-up visits for X-rays and assessments.
• Recovery time: Healing typically takes 6-8 weeks, depending on the severity of the fracture.
• Restrictions: Avoid weight-bearing activities with the affected arm. Engage in gentle exercises as advised.

Alternatives

• Surgical treatment: Open reduction and internal fixation (ORIF) for more severe fractures. ##### Pros and Cons:
• Surgery might ensure better alignment for complex fractures but comes with higher risks and longer recovery.
• Non-surgical treatment is safer but may not be suitable for all fracture types.

Patient Experience

• During the procedure: Minimal discomfort from casting; sedation or anesthesia if used, will ensure comfort.
• After the procedure: Soreness and the weight of the cast might cause some discomfort. Pain management will include over-the-counter pain relievers or prescribed medication.
• Pain Management: Ice packs and elevation can help to reduce pain and swelling.