Name of the Procedure:

Closed Treatment of Humeral Epicondylar Fracture, Medial or Lateral; Without Manipulation

Summary

This procedure involves the non-surgical treatment of a humeral epicondylar fracture without the need to physically move or realign the bone. It primarily involves immobilization to allow natural healing.

Purpose

This procedure addresses fractures of the medial or lateral epicondyle of the humerus. The goal is to ensure the bone heals properly without the need for surgical intervention, reducing pain and restoring function to the affected arm.

Indications

• Visible signs of a fracture on X-ray
• Pain, swelling, and tenderness around the elbow
• Inability to move the elbow or arm normally
• Appropriate for patients where the bone alignment is already satisfactory and no displacement requires manipulation

Preparation

• No specific fasting or medication adjustments are typically needed
• X-ray or other imaging tests to confirm the fracture and assess alignment
• Provide detailed medical history to the healthcare provider

Procedure Description

1. The affected arm is examined and X-rayed.
2. The arm is then immobilized using a cast, splint, or brace to keep the elbow in a stable position.
3. Pain management strategies, such as over-the-counter painkillers, are discussed.
4. The patient is given instructions on maintaining and caring for the cast or splint.

Duration

The initial immobilization process typically takes about 20 to 30 minutes.

Setting

• Outpatient clinic
• Emergency room

Personnel

• Orthopedic surgeon or trained healthcare provider
• Nurses or medical assistants

Risks and Complications

• Stiffness in the elbow
• Swelling
• Pressure sores from the cast or splint
• Delayed union or non-union of the bone

Benefits

• Reduces pain and discomfort
• Supports proper healing of the fracture
• Avoids the risks associated with surgical intervention
• Generally quick and simple to perform

Recovery

• Follow-up appointments for X-rays and to monitor healing
• Instructions for keeping the cast or splint dry and clean
• Physical therapy or exercises may be recommended after the immobilization period
• Typical recovery time can range from 4 to 8 weeks, depending on the patient’s age and overall health

Alternatives

• Surgical treatment if the fracture is displaced or if closed treatment fails
• Manipulation under anesthesia if alignment is not adequate
• Pros: Non-surgical treatments have fewer risks and shorter recovery times
• Cons: Surgery may be more effective for severe or complicated fractures

Patient Experience

• Patients will likely experience some discomfort and immobility in the affected arm
• Pain is usually manageable with over-the-counter pain relief
• Regular follow-up and adherence to care instructions are crucial for a smooth recovery process