25575 Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius AND ulna

Name of the Procedure:

Open Treatment of Radial and Ulnar Shaft Fractures with Internal Fixation (ORIF of Radius and Ulna)

Summary

Open treatment of radial and ulnar shaft fractures, commonly referred to as ORIF (Open Reduction and Internal Fixation) of the Radius and Ulna, is a surgical procedure to repair and stabilize fractures of the forearm bones using plates, screws, or rods.

Purpose

This procedure addresses severe fractures of both the radius and ulna bones in the forearm. The goal is to realign the broken bones and secure them in place to enable proper healing, restore arm function, and prevent long-term disability.

Indications

• Severe or displaced fractures of the radius and ulna
• Open fractures where bone fragments have broken through the skin
• Non-union or malunion of the bones after a previous fracture
• Fractures that do not align properly with non-surgical treatment

Preparation

• Patients may need to fast for a specified period before surgery.
• Routine blood tests, imaging studies (X-rays, CT scans), and a thorough medical assessment are performed.
• Adjustments to medications (e.g., blood thinners) and management of comorbid conditions may be required.

Procedure Description

1. The patient is administered general anesthesia or regional anesthesia.
2. An incision is made over the fractured area on the forearm to expose the bones.
3. The surgeon realigns the bone fragments (reduction).
4. Internal fixation devices such as plates, screws, or rods are used to hold the bones in the correct position.
5. The incision is closed with sutures or staples, and a sterile dressing is applied.
6. A splint or cast may be used to immobilize the arm temporarily.

Duration

The procedure typically takes 1.5 to 3 hours, depending on the complexity of the fractures.

Setting

The procedure is performed in a hospital operating room or a surgical center.

Personnel

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

Risks and Complications

• Infection
• Bleeding
• Damage to blood vessels or nerves
• Nonunion or delayed union of the fractures
• Compartment syndrome
• Hardware failure or irritation

Benefits

• Stabilization and proper alignment of the bones
• Enhanced healing and faster recovery of arm function
• Reduction of pain and prevention of deformity
• Restoration of mobility and strength

Recovery

• Pain management with prescribed medications
• Arm immobilization in a cast or splint for several weeks
• Gradual rehabilitation with physical therapy to regain strength and mobility
• Follow-up appointments to monitor bone healing and evaluate progress
• Full recovery can take several months

Alternatives

• Non-surgical treatment with casting or splinting (suitable for less severe fractures)
• External fixation (using external devices to stabilize fractures)
• Pros and cons: Non-surgical treatments may have longer recovery times and higher chances of malalignment; external fixation is less invasive but may be uncomfortable for long-term use.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Postoperatively, the patient may experience swelling, bruising, and pain, which can be managed with medications. Physical therapy will help improve recovery, and patients should follow all post-operative instructions for optimal outcomes.