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Closed treatment of radial and ulnar shaft fractures; with manipulation
CPT4 code
Name of the Procedure:
Closed Treatment of Radial and Ulnar Shaft Fractures; with Manipulation
Summary
This procedure involves the non-surgical realignment of broken bones in the forearm (specifically the radius and ulna). It is done by manually manipulating the bones back into their correct position.
Purpose
The procedure addresses fractures of the forearm bones (radius and ulna). The primary goal is to realign the bones to their natural position, which promotes proper healing and restores the function of the arm.
Indications
- Fracture of the radial and/or ulnar shafts
- Misalignment of the fractured bones
- Pain, swelling, and deformity in the forearm
- Inability to move the arm correctly
Preparation
- Patients may need to avoid eating or drinking for several hours before the procedure if sedation or anesthesia is required.
- Pre-procedure imaging tests such as X-rays are essential to evaluate the extent of the fractures.
- Patients should inform their doctor about any medications they are taking and any underlying health conditions.
Procedure Description
- The patient may receive sedation or local anesthesia to minimize discomfort.
- The surgeon will manually manipulate the bones into their correct anatomical position.
- During the manipulation, continuous X-ray imaging may be used to ensure proper alignment.
- Once the bones are aligned, the arm is immobilized using a cast or splint to maintain the correct position during healing.
- Follow-up X-rays may be taken to ensure the bones remain properly positioned.
Duration
The procedure typically takes about 30 to 60 minutes, depending on the complexity of the fractures.
Setting
The procedure is usually performed in a hospital emergency room, outpatient clinic, or surgical center.
Personnel
- Orthopedic surgeon or emergency room physician
- Nurses
- Radiology technicians
- Anesthesiologist (if sedation is used)
Risks and Complications
- Infection
- Nerve or blood vessel damage
- Misalignment of the bones (malunion)
- Nonunion (failure of the bones to heal)
- Compartment syndrome (increased pressure within the muscles)
Benefits
- Proper alignment of the fractured bones, promoting optimal healing
- Restoration of arm function
- Reduced pain and deformity
- Avoidance of surgical intervention
Recovery
- Immediate immobilization with a cast or splint for several weeks.
- Follow-up appointments for X-rays to monitor bone healing.
- Physical therapy may be required to restore strength and mobility.
- Most patients can expect a full recovery within 6 to 12 weeks, with some restrictions on lifting and strenuous activities during the healing period.
Alternatives
- Surgical treatment with internal fixation (use of plates, screws, or rods)
- External fixation
- Pros of surgery: potentially better alignment and stabilization
- Cons of surgery: higher risk of infection, longer recovery time, and surgical risks
Patient Experience
- During the procedure, patients may feel pressure or pulling while the bones are being manipulated.
- Pain and discomfort can be managed with pain medications prescribed by the healthcare provider.
- Post-procedure, the patient may experience swelling and bruising around the fracture site.
- Keeping the arm elevated and applying ice can help reduce swelling and pain.
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