Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed
CPT4 code
Name of the Procedure:
Open Treatment of Humeral Epicondylar Fracture (Medial or Lateral)
Common names: Surgical Treatment of Elbow Fracture, Internal Fixation of Humeral Epicondyle Fracture
Summary
The open treatment of a humeral epicondylar fracture involves surgically exposing the broken part of the arm bone near the elbow, realigning the bone fragments, and using hardware like screws and plates to secure them in place.
Purpose
This procedure addresses fractures of the humeral epicondyle, which is a part of the elbow joint. The goal is to stabilize the bone, ensure proper healing, and restore normal function to the elbow and arm.
Indications
- Severe pain and swelling around the elbow
- Visible deformity or displacement of the elbow
- Inability to move the elbow or arm
- Fractures that are not aligned properly
- Compound or open fractures where the bone has broken through the skin
Preparation
- Fasting for 8 hours prior to surgery
- Adjusting or stopping certain medications as advised by the doctor
- Undergoing pre-operative assessments such as X-rays or MRIs to evaluate the fracture
Procedure Description
- Anesthesia: General anesthesia is commonly used.
- Incision: A surgical cut is made over the fracture site.
- Exposure: The bone fragments are exposed by carefully moving aside muscles and tissues.
- Reduction: The bone fragments are realigned to their correct positions.
- Fixation: Metal screws, plates, or pins are used to hold the bone fragments in place.
- Closure: The incision is closed with sutures, and the area is bandaged.
Duration
The procedure typically takes 1.5 to 2 hours, depending on the complexity of the fracture.
Setting
This surgery is usually performed in a hospital or a specialized surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Surgical Technicians
Risks and Complications
- Infection at the surgical site
- Blood clots
- Nerve or blood vessel damage
- Non-union or improper healing of the fracture
- Allergic reaction to anesthesia
- Stiffness or loss of movement in the elbow
Benefits
- Proper alignment and stabilization of the bone
- Reduced pain and faster healing process
- Restoration of normal elbow and arm function
- Prevention of long-term complications such as arthritis
Recovery
- Post-operative physical therapy to regain motion and strength
- Pain management using prescribed medications
- Keeping the arm in a sling or immobilizer as directed
- Follow-up visits to monitor healing with X-rays
- Gradual return to normal activities over 6 to 12 weeks
Alternatives
- Non-surgical treatment with casting or splinting (suitable for less severe fractures)
- Percutaneous pinning (minimally invasive fixation technique)
- Pros: Non-surgical options avoid surgical risks
- Cons: May not provide as stable a repair for more severe fractures
Patient Experience
During the procedure, the patient will be under general anesthesia and not feel anything. Post-surgery, some discomfort and pain management are expected. Physical therapy is often required to regain full motion and strength. The surgical team will provide specific instructions to aid in a smooth recovery.