Name of the Procedure:

Open Treatment of Distal Radial Extra-Articular Fracture or Epiphyseal Separation with Internal Fixation

Summary

This procedure involves surgically setting a broken distal radius, the bone in the forearm near the wrist, using internal devices like plates, screws, or pins to hold the bone in place as it heals. It is typically performed when the break is severe and the bone cannot be aligned properly through a cast or brace alone.

Purpose

• Medical Condition: This procedure addresses fractures of the distal radius that do not extend into the wrist joint.
• Goals: The primary goals are to realign the broken bone, ensure proper healing, restore function and strength, and minimize potential complications like improper healing or arthritis.

Indications

• Severe distal radial fractures that cannot be corrected with casting alone.
• Displaced fractures where the bone pieces have moved out of alignment.
• Epiphyseal separations especially in children and adolescents.
• Patients with symptoms of severe pain, swelling, and inability to use the affected wrist.

Preparation

• Pre-Procedure Instructions: Patients may need to fast for several hours before surgery.
• Medication Adjustments: Adjustments may be required for medications that affect bleeding.
• Diagnostic Tests: Preoperative imaging like X-rays or CT scans to assess the fracture.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered for patient comfort.
2. Incision: A surgical cut is made near the wrist to access the broken bone.
3. Reduction: The bone fragments are realigned to their normal positions.
4. Internal Fixation: Metal plates, screws, or pins are used to hold the bone fragments together.
5. Closure: The incision is closed with sutures or staples and covered with a sterile bandage.

Duration

The procedure typically takes 1 to 2 hours.

Setting

This procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon: Orthopedic surgeon.
• Nurses: Operating room nurses and surgical assistants.
• Anesthesiologist: For administering anesthesia.

Risks and Complications

• Common Risks: Infection, bleeding, and swelling.
• Rare Risks: Nerve damage, non-union or malunion of the bone, need for additional surgery, and anesthesia-related complications.

Benefits

• Proper alignment and stabilization of the bone.
• Fast and effective recovery of wrist function.
• Prevention of long-term complications such as arthritis. Benefits are usually realized within weeks to months after surgery as the bone heals.

Recovery

• Post-Procedure Care: Keeping the surgical site clean, using prescribed pain medications, wearing a cast or splint, and attending physical therapy.
• Recovery Time: Full recovery can take 6 weeks to 3 months.
• Follow-Up: Regular check-ups with the surgeon to monitor healing.

Alternatives

• Non-Surgical Options: Casting or splinting for less severe fractures.
• Pros and Cons: Non-surgical methods involve less risk but may not achieve as precise alignment. Surgical methods are more invasive but generally ensure better healing and function.

Patient Experience

• During the procedure, the patient will be under anesthesia and won't feel any pain.
• Post-surgery, expect some pain, swelling, and discomfort managed through medications.
• Physical therapy will be essential for regaining strength and mobility in the wrist.
• Patients can expect gradual improvement over several weeks to months.