Name of the Procedure:

Closed treatment of humeral condylar fracture, medial or lateral; without manipulation
(Non-surgical treatment of a cracked elbow bone without moving it)

Summary

A closed treatment of a humeral condylar fracture without manipulation is a non-surgical method used to heal a break in either the inner or outer part of the elbow bone. This procedure involves immobilizing the fracture with a cast or brace to allow natural healing without physically adjusting or realigning the bone.

Purpose

This procedure addresses fractures in the medial (inner) or lateral (outer) condyle of the humerus (upper arm bone) near the elbow. The goal is to stabilize the bone to enable natural healing and prevent further injury without the need for surgery.

Indications

• Acute pain, swelling, and tenderness around the elbow.
• Confirmed fracture of the medial or lateral condyle of the humerus via X-ray.
• Stable fractures where bone alignment is deemed satisfactory by the healthcare provider.
• Patients without significant displacement of bone fragments.

Preparation

• No specific pre-procedure fasting or medication adjustments are typically required.
• A diagnostic X-ray or CT scan of the elbow will be performed to assess the fracture.
• The patient should provide a complete medical history, including current medications and allergies.

Procedure Description

1. Assessment: The healthcare provider reviews the fracture via imaging.
2. Immobilization: The affected arm is placed into a cast, brace, or splint.
   • Cast/brace applied to elbow ensuring it is secured in place.
   • Close monitoring to ensure proper circulation and comfort.
3. Follow-up imaging: X-rays may be taken periodically to ensure the bone is healing correctly.
4. Patient Instructions: Guidance on caring for the cast and recognizing signs of complications.

Duration

Initial immobilization takes about 30-60 minutes. Overall healing and follow-up can span several weeks to months.

Setting

Typically performed in an outpatient clinic, emergency department, or orthopedic office.

Personnel

• Orthopedic surgeon or physician.
• Nurse or medical assistant.
• Radiology technician (for imaging).

Risks and Complications

• Cast discomfort or tightness.
• Swelling under the cast.
• Potential for skin irritation or sores.
• Rarely, improper healing (malunion) or non-healing (nonunion) of the bone.

Benefits

• Non-invasive with no surgical risks.
• Effective in stabilizing and allowing natural healing of the fracture.
• Lower cost and fewer complications compared to surgical options.

Recovery

• Regular follow-up appointments to monitor bone healing via X-rays.
• Proper care and hygiene instructions for the cast.
• Avoidance of strenuous activities until healed, typically 6-12 weeks.
• Physical therapy may be recommended to restore movement and strength after cast removal.

Alternatives

• Surgical Treatment: For more severe or unstable fractures.
  • Pros: Precise bone realignment, potentially faster recovery.
  • Cons: Surgical risks, higher costs, longer initial recovery.
• Manipulation Under Anesthesia and Closed Reduction: For fractures needing bone realignment without full open surgery.
  • Pros: Minimally invasive.
  • Cons: Requires anesthesia, potential need for surgery if realignment fails.

Patient Experience

• Mild discomfort during cast application.
• Moderate pain and swelling initially, managed with prescribed pain relief.
• Limited mobility and activity restrictions until healing progresses.
• Regular follow-up visits to ensure proper healing and guidance on care.