Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed
CPT4 code
Name of the Procedure:
Open Treatment of Humeral Condylar Fracture, Medial or Lateral, Includes Internal Fixation (Medial or Lateral Condylar Open Reduction and Internal Fixation, ORIF)
Summary
In layman's terms, this surgical procedure involves repairing a fractured part of the upper arm bone known as the humeral condyle. The surgery is performed to properly align the broken bone pieces and stabilize them with internal devices like screws or plates. This helps ensure proper healing and functionality of the arm.
Purpose
The procedure addresses fractures of the medial or lateral humeral condyle. The main goals are to stabilize the broken bone pieces, promote proper healing, and restore normal arm function. Without proper treatment, these fractures can result in improper healing, chronic pain, and reduced mobility.
Indications
- Severe pain and swelling in the elbow or upper arm area.
- Inability to move the arm normally.
- Visible deformity or abnormal alignment of the arm.
- X-rays or imaging studies confirming a fracture of the humeral condyle.
- Patients not responding to non-surgical treatments.
Preparation
- Patients may need to fast for several hours prior to surgery.
- Adjustment or discontinuation of certain medications as instructed by the surgeon.
- Pre-operative diagnostic tests such as X-rays, MRI, or CT scans.
- Blood tests to ensure overall health and readiness for surgery.
Procedure Description
- Anesthesia: The procedure starts with the administration of general anesthesia or a regional block.
- Incision: A surgical incision is made over the fracture site.
- Exposure: The muscles and tissues are carefully moved to expose the fractured bone.
- Reduction: The surgeon aligns the broken bone pieces into their normal position.
- Fixation: Internal fixation devices like screws, plates, or pins are used to stabilize the fracture.
- Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.
Duration
The procedure typically takes around 2 to 3 hours.
Setting
The surgery is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic surgeon.
- Anesthesiologist.
- Surgical nurses.
- Surgical technologists.
Risks and Complications
- Infection at the surgical site.
- Bleeding or blood clots.
- Nerve or blood vessel damage.
- Non-union or delayed healing of the fracture.
- Hardware irritation or failure.
- Anesthesia-related risks.
Benefits
- Proper alignment and stabilization of the fracture.
- Reduced pain and improved arm function.
- Enhanced healing process.
- Lower risk of long-term complications.
Recovery
- Patients may need to stay in the hospital for a day or two.
- Pain management with medications.
- Arm immobilization with a splint or cast initially.
- Gradual physical therapy to restore motion and strength.
- Regular follow-up appointments to monitor healing.
- Recovery time varies but generally takes several weeks to months.
Alternatives
- Non-surgical options like casting or bracing (may not be suitable for severe fractures).
- Closed reduction and percutaneous pinning (for less complex fractures).
- Pros and Cons: Non-surgical options involve less immediate risk but may not provide the same level of fracture stability and healing.
Patient Experience
- During the procedure: Patients will be under anesthesia and will not feel any pain.
- After the procedure: Pain and discomfort managed with medications.
- Some swelling and bruising around the incision site are normal.
- Gradual return to normal activities with specific restrictions as advised by the surgeon.