25526 Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/ dislocation), includes internal fixation, when performed, includes repair of triangular fibr

Name of the Procedure:

Open treatment of radial shaft fracture and distal radioulnar joint dislocation (Galeazzi fracture/dislocation), including internal fixation and repair of the triangular fibrocartilage complex (TFCC).

Summary

This procedure involves surgically repairing a broken radial shaft and a dislocated distal radioulnar joint. The procedure includes the use of internal fixation devices (like plates and screws) to align and stabilize the bones, as well as the repair of the triangular fibrocartilage complex (TFCC) to restore wrist function.

Purpose

This surgery addresses fractures of the radial shaft and dislocations of the distal radioulnar joint, known together as Galeazzi fractures. The goal is to realign and stabilize the bones, enabling proper healing, and restoring the normal function of the wrist and forearm.

Indications

• Severe or displaced radial shaft fractures
• Distal radioulnar joint dislocation
• Pain, deformity, and loss of function in the wrist and forearm
• Inability for the fractured and dislocated bones to heal properly with conservative treatment methods like casting

Preparation

• Fasting for at least 6 to 12 hours before surgery
• Medication adjustments as directed by the physician
• Preoperative imaging studies such as X-rays or CT scans
• Blood tests and a thorough health evaluation to assess fitness for surgery

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made over the forearm to access the fractured radial shaft and the dislocated distal radioulnar joint.
3. The fractured radial shaft is realigned and fixed using plates and screws.
4. The dislocated distal radioulnar joint is reduced (repositioned).
5. The triangular fibrocartilage complex (TFCC) is repaired if damaged.
6. The incision is closed with sutures, and the area is bandaged.

Duration

The procedure typically takes 2 to 3 hours.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Surgical assistants
• Anesthesiologist
• Operating room nurses and technicians

Risks and Complications

• Infection at the surgical site
• Nerve or blood vessel injury
• Nonunion or malunion of the fracture
• Persistent pain or stiffness
• Complications related to anesthesia
• Potential need for additional surgeries

Benefits

• Proper alignment and healing of the fractured radial shaft and dislocated joint
• Restoration of wrist and forearm function
• Reduction in pain and prevention of long-term disability

Recovery

• Hospital stay of 1 to 2 days post-surgery
• Pain management with prescribed medications
• Wearing a cast or splint to immobilize the wrist and forearm for several weeks
• Physical therapy to restore strength and range of motion
• Follow-up appointments to monitor healing progress
• Full recovery might take several months

Alternatives

• Conservative treatment (casting or splinting), typically not sufficient for severe fractures or dislocations
• Closed reduction and percutaneous fixation, less invasive but not always possible or effective
• Pros and cons vary based on the severity of the injury, patient health, and specific case details

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Post-surgery, the patient may experience discomfort, swelling, and limited mobility, which will be managed through pain relief medications and physical therapy. Full functional recovery may take several months, with consistent follow-up and rehabilitation.