Name of the Procedure:

Open Treatment of Humeral Supracondylar or Transcondylar Fracture, includes Internal Fixation, when performed; without Intercondylar Extension

Summary

This procedure involves surgically repairing a broken bone in the upper arm (humerus) near the elbow, without involving the elbow joint itself. The surgery includes using internal devices like plates, screws, or rods to stabilize the fracture and facilitate proper healing.

Purpose

The procedure is done to stabilize and heal fractures of the humerus near the elbow (supracondylar or transcondylar fractures) to restore normal arm function. The main goals are to align the bone correctly, relieve pain, and prevent complications such as improper bone healing or nerve damage.

Indications

• Visible deformity or severe pain after an injury
• Difficulty moving the arm or elbow
• Numbness or tingling in the hand, indicating nerve involvement
• X-ray or imaging studies confirming a supracondylar or transcondylar fracture without intercondylar extension

Preparation

• Patients are typically instructed to fast for at least 8 hours before surgery.
• Medication adjustments, especially blood thinners, will be provided by the healthcare team.
• Pre-operative assessments may include blood tests, an EKG, and imaging studies such as X-rays or CT scans to evaluate the fracture.

Procedure Description

1. The patient is placed under general anesthesia.
2. The surgeon makes an incision over the fractured area.
3. The broken bone fragments are realigned (reduced).
4. Internal fixation devices, like plates and screws, are placed to hold the bone fragments together.
5. The incision is closed with sutures or staples.
6. A sterile dressing is applied to the surgical site.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity of the fracture.

Setting

This surgery is usually performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technician

Risks and Complications

• Infection at the surgical site
• Blood clots
• Nerve damage
• Bleeding
• Nonunion or malunion of the bone
• Allergic reaction to anesthesia

Benefits

• Proper alignment and stabilization of the fracture
• Enhanced likelihood of full recovery of arm function
• Reduced pain and discomfort
• Prevention of long-term complications such as deformities or nerve damage

Recovery

• Patients may need to stay in the hospital for a couple of days for monitoring.
• Pain management with medication will be provided.
• Arm immobilization with a cast or splint as per the surgeon’s advice.
• Physical therapy may be recommended to restore function and strength.
• Recovery time varies but generally ranges from 6 to 12 weeks.
• Follow-up appointments will be necessary to monitor healing.

Alternatives

• Non-surgical treatment with casting or bracing if the fracture is less severe (though less effective for complex fractures).
• Closed reduction and percutaneous pinning (a less invasive procedure).
• Pros and cons should be discussed with the healthcare provider to determine the best approach.

Patient Experience

• Patients will be under general anesthesia and won’t feel anything during the procedure.
• Post-operatively, patients may experience pain, which will be managed with medication.
• Mild discomfort and swelling are common.
• Rehabilitation and physical therapy will be part of the recovery process to regain full arm function.