Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed
CPT4 code
Name of the Procedure:
Open Treatment of Radial Head or Neck Fracture, Including Internal Fixation or Radial Head Excision
Summary
In this procedure, a surgeon repairs a broken bone in the elbow called the radial head or neck, which is found at the upper end of the radius. The procedure may involve the use of metal hardware (internal fixation) to hold the bone together or the removal of the radial head (radial head excision), if necessary.
Purpose
This procedure addresses fractures of the radial head or neck that may not heal properly on their own or might lead to long-term issues such as stiffness, pain, or loss of function in the elbow. The goal is to restore the normal alignment and function of the elbow by stabilizing the fracture or removing damaged bone.
Indications
- Severe pain and swelling in the elbow following trauma.
- Inability to move the elbow or forearm.
- X-rays or other imaging showing a fracture in the radial head or neck.
- Cases where conservative treatment (e.g., casting or splints) is insufficient.
Preparation
- Fasting for at least six hours before the procedure.
- Temporary cessation of certain medications such as blood thinners, as advised by the doctor.
- Preoperative imaging tests like X-rays, CT scans, or MRIs to assess the extent of the fracture.
- Routine blood tests and health assessments.
Procedure Description
- The patient is administered general anesthesia or regional anesthesia.
- An incision is made over the elbow to expose the fractured bone.
- If internal fixation is used, metal screws or plates are applied to stabilize the bone fragments.
- If radial head excision is performed, the damaged radial head is carefully removed.
- The incision is closed with sutures or staples, and a sterile bandage is applied.
- The arm may be placed in a splint or cast to keep it immobilized during initial healing.
Duration
The procedure typically takes between 1 to 3 hours.
Setting
The procedure is performed in a hospital operating room or a surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologists
- Radiologic technologist (if intraoperative imaging is required)
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma
- Nerve or blood vessel damage
- Stiffness or decreased range of motion in the elbow
- Nonunion or malunion of the fracture
- Need for additional surgery
Benefits
- Relief from pain and improved elbow function
- Stabilization of the fractured bone for proper healing
- Prevention of long-term complications such as arthritis
Recovery
- Pain management with medications and ice packs.
- Elevation of the arm to reduce swelling.
- The arm may need to be immobilized in a splint or cast for several weeks.
- Physical therapy exercises to regain strength and range of motion.
- Full recovery may take several months, with follow-up appointments to monitor healing.
Alternatives
- Non-surgical treatment with slings, splints, or casts in minor fractures.
- Closed reduction and percutaneous pinning for specific fracture types.
- Benefits of the open treatment include better alignment and quicker return to function; non-surgical approaches may be less invasive but are often less effective for severe fractures.
Patient Experience
- Patients may experience pain and discomfort post-surgery, which can be managed with pain relief medications.
- During recovery, activities will be limited, and adherence to physical therapy is crucial for regaining function.
- With proper care, patients can expect significant improvement in elbow mobility and strength.