25535 Closed treatment of ulnar shaft fracture; with manipulation

Name of the Procedure:

Closed Treatment of Ulnar Shaft Fracture with Manipulation

Summary

This procedure involves the non-surgical realignment and stabilization of a broken ulna, one of the long bones in the forearm. It is known as a "closed" treatment because it does not involve any surgical incisions.

Purpose

The main purpose of this procedure is to realign the broken segments of the ulnar bone and facilitate proper healing. This helps restore the normal function of the arm and minimizes the risk of future complications or deformities.

Indications

• Pain, swelling, and deformity in the forearm after an injury.
• Confirmed ulnar shaft fracture through X-ray or other imaging techniques.
• Good overall health status to undergo the manipulation without surgical intervention.
• No significant open wounds or infection at the fracture site.

Preparation

• Fasting for a few hours if sedation is required.
• Informing the doctor of any medications, especially blood thinners.
• Diagnostic X-rays to assess the fracture.

Procedure Description

1. The patient is positioned comfortably, usually lying down.
2. Local anesthesia or sedation may be administered to minimize discomfort.
3. The healthcare provider manipulates the forearm to realign the bone fragments.
4. Once proper alignment is confirmed via imaging, the arm is typically immobilized using a cast or splint.
5. Periodic X-rays may be taken to ensure the bone remains properly aligned during healing.

Duration

The procedure typically takes around 30 to 60 minutes, though it might be longer if anesthesia is used.

Setting

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

Personnel

• Orthopedic surgeon or trained healthcare provider.
• Nurse or medical assistant.
• Anesthesiologist, if sedation is required.

Risks and Complications

• Pain and swelling at the fracture site.
• Re-displacement of the fracture.
• Nerve or blood vessel injury.
• Adverse reaction to anesthesia.
• Infection (rare in closed procedures).

Benefits

• Realigns bone for proper healing.
• Reduces pain and restores function.
• Generally quicker and less invasive than surgical options.
• The benefits are usually noticeable within a few weeks, but full healing may take several months.

Recovery

• The patient will need to keep the arm elevated and apply ice packs to reduce swelling.
• Pain medication may be prescribed.
• Follow-up appointments for X-rays and cast adjustments.
• Physical activity will be limited, and instructions for gradual movement will be provided as healing progresses.
• Physical therapy might be required to regain full function.

Alternatives

• Open surgical fixation with internal plates or rods.
• Functional bracing without manipulation.
• Each alternative has its own set of pros and cons, such as longer recovery time or higher surgical risks.

Patient Experience

• The patient might feel pressure or discomfort during the manipulation.
• Post-procedure soreness is common but can be managed with painkillers.
• The immobilization device (cast or splint) could cause some inconvenience but is crucial for proper healing.