Name of the Procedure:

Closed Treatment of Radial Head or Neck Fracture; with Manipulation

Summary

This procedure involves the non-surgical realignment and stabilization of a fractured radial head or neck in the elbow. Using manual manipulation, the healthcare provider repositions the bone fragments to their proper alignment without making any incisions.

Purpose

The procedure addresses fractures involving the radial head or neck, commonly resulting from falls or direct trauma to the elbow. The goals are to realign the fractured bone, promote proper healing, and restore normal elbow function.

Indications

• Pain, swelling, or deformity in the elbow area after a fall or direct impact.
• Inability to move the elbow or a visible misshaping of the elbow.
• Confirmation of radial head or neck fracture via X-ray or other imaging.

Preparation

• Patients may need to undergo imaging studies like X-rays or CT scans.
• Fasting is usually not required.
• The healthcare provider may instruct on medication adjustments, particularly blood thinners.

Procedure Description

1. The patient is positioned comfortably, usually in a reclining or supine position.
2. Local anesthesia or sedation may be administered to minimize discomfort.
3. The healthcare provider manually manipulates the elbow to realign the radial head or neck within the joint.
4. Once alignment is achieved, a splint or cast is applied to immobilize the elbow, ensuring the bone maintains proper positioning as it heals.
5. Follow-up X-rays may be taken to confirm the successful realignment.

Duration

The procedure typically takes about 30 to 60 minutes, depending on the complexity of the fracture.

Setting

This procedure is usually performed in an outpatient clinic or an emergency department setting.

Personnel

• Orthopedic surgeon or specialized physician
• Radiologic technician (if imaging is required)
• Nurse or medical assistant
• Anesthesiologist, if sedation or more extensive pain management is necessary

Risks and Complications

• Pain and discomfort during manipulation
• Swelling and bruising
• Nerve or blood vessel injury
• Incomplete or improper healing of the fracture
• Stiffness or reduced range of motion in the elbow

Benefits

• Non-invasive treatment with no surgical incisions
• Shorter recovery time compared to surgical options
• Successful bone realignment and healing, leading to restored elbow function
• Pain relief and improved mobility

Recovery

• The patient will need to wear a splint or cast for several weeks, typically 4 to 6 weeks.
• Pain management may include prescribed pain relievers and ice application.
• Physical therapy may be recommended to restore mobility and strength.
• Follow-up appointments are necessary to monitor healing through X-rays and clinical evaluations.

Alternatives

• Surgical intervention if closed treatment is unsuccessful or if the fracture is complex.
• Conservative management with immobilization alone, though this may result in improper alignment.
• Each alternative has its pros and cons; surgical options may offer a better outcome for severe fractures but involve longer recovery and higher risk.

Patient Experience

• During the procedure, patients may feel pressure or brief discomfort despite anesthesia.
• Post-procedure, there may be pain and swelling managed with medication.
• Mobility will be limited due to splint or cast application.
• Follow-up care includes monitoring, physical therapy, and possibly additional imaging.
• Full recovery can take several weeks to months with gradual improvement in elbow function.