25415 Repair of nonunion or malunion, radius AND ulna; without graft (eg, compression technique)

Name of the Procedure:

Repair of Nonunion or Malunion, Radius and Ulna; Without Graft (e.g., Compression Technique)

Summary

This surgical procedure fixes improper healing of the radius and ulna bones in the forearm. It uses a technique called compression to realign the bones without needing a bone graft.

Purpose

Addresses issues where the radius and ulna have not healed properly after a fracture (nonunion) or have healed in the wrong position (malunion). Aims to restore proper bone alignment and function, reduce pain, and improve the range of motion.

Indications

• Persistent pain or discomfort in the forearm.
• Visible deformity or abnormal alignment of the forearm.
• Impaired movement or function of the wrist, forearm, or hand.
• Non-healing fracture despite extended time after initial treatment.

Preparation

• Fasting for a specified period before the procedure.
• Adjustments to medications (especially blood thinners).
• Pre-procedure imaging tests such as X-rays or CT scans to assess the bone condition.

Procedure Description

1. Administer general anesthesia or regional anesthesia.
2. Make an incision over the affected area of the forearm.
3. Carefully expose and clean the fracture site.
4. Realign the bones using a compression technique to hold them firmly together.
5. Secure the bones with plates, screws, or other fixation devices.
6. Close the incision with sutures or staples and apply a sterile dressing.

Duration

The procedure typically takes about 2 to 3 hours, depending on the complexity of the case.

Setting

Performed in a hospital operating room or a surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection at the surgical site.
• Blood clots or deep vein thrombosis (DVT).
• Nerve or blood vessel damage.
• Hardware failure or irritation.
• Non-healing or recurrence of nonunion or malunion.
• Anesthesia-related risks.

Benefits

• Proper alignment and healing of the radius and ulna.
• Reduction or elimination of pain.
• Improved function and mobility of the forearm and hand.
• Enhanced quality of life and ability to perform daily activities.

Recovery

• Immobilization with a cast or brace for several weeks.
• Pain management with prescribed medications.
• Physical therapy to restore strength and mobility.
• Regular follow-up appointments for X-rays and progress monitoring.
• Full recovery typically takes several months.

Alternatives

• Non-surgical methods like bracing or physical therapy (often less effective for severe cases).
• Use of bone grafts in other types of nonunion or malunion repairs.
• External fixation devices.

Patient Experience

• Patients will be under anesthesia and will not feel pain during the procedure.
• Post-operative pain can be managed with medications.
• Expect soreness, swelling, and limited use of the affected arm during the initial recovery period.
• Gradual improvement in pain and functionality as healing progresses with adherence to rehabilitation protocols.