25515 Open treatment of radial shaft fracture, includes internal fixation, when performed

Name of the Procedure:

Open Treatment of Radial Shaft Fracture, Includes Internal Fixation
Common Names: ORIF (Open Reduction and Internal Fixation) for Radial Shaft Fracture

Summary

Open treatment of a radial shaft fracture involves surgically exposing the broken bone and using internal devices such as plates, screws, or rods to stabilize and align the bone fragments. This procedure helps to ensure proper healing and restore functionality to the arm.

Purpose

The procedure addresses fractures of the radial shaft, which is the long bone in the forearm. The goals are to realign the bone fragments, stabilize the fracture, and allow for proper healing, ultimately restoring normal arm function and reducing pain.

Indications

• Severe fractures where the bone fragments are misaligned.
• Fractures that cannot be adequately treated with a cast or splint.
• Patients with multiple fractures or complex injuries.
• Non-union fractures where the bone fails to heal with non-surgical methods.

Preparation

• Patients may need to fast for several hours before the surgery.
• Medication adjustments might be required, especially blood thinners.
• Preoperative assessments may include X-rays, MRI, or CT scans to evaluate the fracture.
• Consent forms and preoperative discussions regarding the procedure and anesthesia.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A surgical incision is made over the radial shaft to expose the fracture site.
3. Reduction: The bone fragments are realigned (reduced) to their normal anatomical position.
4. Fixation: Internal devices such as plates and screws are secured to the bone to stabilize the fracture.
5. Closure: The surgical incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 1-2 hours, depending on the complexity of the fracture.

Setting

Performed in a hospital operating room or a surgical center equipped for orthopedic surgery.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technician

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.
• Allergic reactions to anesthesia or materials used for internal fixation.
• Hardware irritation or need for hardware removal.

Benefits

• Proper alignment and stabilization of the fracture.
• Reduced pain and faster recovery compared to non-surgical methods.
• Improved functionality and strength of the arm.
• Higher likelihood of successful bone healing.

Recovery

• Patients may wear a splint or brace post-surgery to protect the arm.
• Pain medication and ice packs to reduce swelling and discomfort.
• Physical therapy to restore movement and strength.
• Follow-up appointments to monitor healing through X-rays.
• Most patients can return to normal activities within 3-6 months, depending on the severity of the fracture.

Alternatives

• Non-surgical methods such as casting or splinting, suitable for less severe fractures.
• External fixation, using devices outside the skin to stabilize bones.
• Each alternative has pros and cons; non-surgical methods may result in longer healing times and less precise alignment.

Patient Experience

• Patients may feel discomfort or pain managed through medications.
• Immediate post-operative swelling and bruising are common.
• Physical therapy may be challenging but essential for recovery.
• Emotional support and reassurance are beneficial during the recovery phase.