25545 Open treatment of ulnar shaft fracture, includes internal fixation, when performed

Name of the Procedure:

Open Treatment of Ulnar Shaft Fracture with Internal Fixation
Common name(s): Open Reduction and Internal Fixation (ORIF) of the Ulna

Summary

This surgical procedure involves the realignment of a fractured ulna (one of the bones in the forearm) by making an incision to access the bone and using internal devices such as plates and screws to secure the bone fragments in place.

Purpose

This procedure addresses fractures of the ulnar shaft when the bone is broken or fractured and needs stabilization to heal correctly. The goal is to perfectly align the bone segments to promote proper healing, prevent deformities, and restore function and strength to the arm.

Indications

• Fractures of the ulnar shaft that are displaced or unstable.
• Open fractures where the bone has punctured the skin.
• Fractures that have failed to heal with non-surgical treatment.
• Fractures associated with other injuries to bones or soft tissues.

Preparation

• Patients may be instructed to fast for 8-12 hours before the procedure.
• Adjustments to medications, especially blood thinners, may be required.
• Preoperative imaging tests such as X-rays or CT scans are conducted to assess the fracture.

Procedure Description

• The procedure is typically done under general anesthesia.
• An incision is made over the site of the fracture.
• The surgeon carefully realigns the bone fragments.
• Metal plates, screws, or rods are used to secure the fragments in their correct anatomical position.
• The incision is closed with sutures or staples, and a sterile dressing is applied.
• The arm may be immobilized in a splint or cast post-surgery.

Duration

The procedure generally takes around 1 to 2 hours, depending on the complexity of the fracture.

Setting

Performed in a hospital or surgical center in a sterile operating room.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses and technicians
• Radiologic technologist (if intraoperative imaging is needed)

Risks and Complications

• Infection
• Blood clots
• Nerve or blood vessel damage
• Nonunion or delayed healing of the fracture
• Allergic reaction to anesthesia
• Hardware irritation or failure

Benefits

• Proper alignment and stabilization of the fracture.
• Accelerated and more effective healing process.
• Reduced risk of long-term complications such as malunion or loss of function.
• Pain relief and improved arm mobility.

Recovery

• Initial recovery and immobilization may last several weeks.
• Pain management with prescribed medications.
• Physical therapy might be recommended to restore strength and range of motion.
• Follow-up appointments for X-rays and to monitor healing progress.
• Restrictions on heavy lifting and strenuous activities until cleared by the surgeon.

Alternatives

• Non-surgical treatments such as casting or splinting.
• External fixation, where pins and a frame are used outside the body to stabilize the bone.
• Non-surgical options may carry risks of improper healing or prolonged immobilization.

Patient Experience

• Patients might experience discomfort and swelling immediately after the procedure.
• Pain management with medication will be provided.
• Postoperative instructions will include wound care, activity restrictions, and signs of complications to watch for.
• Gradual improvement in pain and function over the weeks and months following surgery.