24586 Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius)

Name of the Procedure:

Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius)

• Common Names: Open reduction and internal fixation (ORIF) of elbow fractures, Elbow fracture surgery

Summary

This surgical procedure involves the open reduction and internal fixation of a broken elbow, specifically fractures involving the lower end of the humerus, the upper end of the ulna, and/or the upper end of the radius. The surgery aims to realign the bones properly and secure them in place with hardware such as plates, screws, or pins to facilitate proper healing.

Purpose

• Treat fractures and dislocations around the elbow joint.
• Restore normal alignment and stability of the elbow.

• Improve function and range of motion.

  Indications

• Severe fractures and dislocations of the elbow that cannot be treated with casting or splinting.
• Open fractures where the bone has punctured the skin.
• Unstable or multiple fractures.
• Failure of conservative treatments (e.g., previous casting not successful).

Preparation

• Patients may need to fast for 6-12 hours before the procedure.
• Medication adjustments, especially blood thinners, may be necessary.
• Pre-operative imaging studies such as X-rays, CT scans, or MRIs to assess the extent of the injury.

Procedure Description

1. Anesthesia: General anesthesia or regional block is administered.
2. Incision: A surgical incision is made over the elbow to expose the fractured bones.
3. Reduction: The bones are realigned anatomically.
4. Fixation: Metal plates, screws, or pins are inserted to hold the bones in place.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 2-3 hours, depending on the complexity of the fractures.

Setting

Performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist
• Radiology technician (optional, for intraoperative imaging)

Risks and Complications

• Infection at the surgical site.
• Nerve or blood vessel injury.
• Nonunion or malunion of the fracture.
• Hardware irritation or failure.
• Stiffness or loss of range of motion in the elbow.
• Complications related to anesthesia.

Benefits

• Proper alignment and stabilization of fractures.
• Improved elbow function and mobility.
• Decreased risk of long-term complications such as arthritis or chronic pain.
• Enhanced healing process.

Recovery

• Post-operative pain management with medications.
• Elevation and icing of the limb to reduce swelling.
• Physical therapy initiation within a few weeks to restore function.
• Restrictions on heavy lifting or elbow movement for 6-12 weeks.
• Follow-up appointments for X-rays to monitor healing.

Alternatives

• Non-surgical treatments, such as casting or splinting (may not be effective for severe fractures).
• Closed reduction (manipulation of the bone without surgery).
• External fixation (using a frame outside the body to stabilize the bones).

Patient Experience

• During the procedure: The patient will be under anesthesia and should not feel pain.
• After the procedure: Post-operative pain is managed with medications; discomfort and swelling are expected.
• Adherence to recovery instructions and physical therapy is critical for optimal outcomes and pain management.