Name of the Procedure:

Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone.

Summary

This procedure involves treating a fracture in one of the carpal bones of the wrist without the need for surgical manipulation. The carpal bones are eight small bones that make up the wrist, and this procedure excludes treatment of the scaphoid bone.

Purpose

This procedure addresses fractures in the carpal bones of the wrist. The goal is to stabilize the bone, allowing it to heal properly and restoring normal function and movement of the wrist.

Indications

• Wrist pain and swelling following trauma.
• X-ray confirmation of a carpal bone fracture.
• Patients who do not require surgical intervention or manipulation for bone realignment.

Preparation

• A thorough physical examination and medical history review.
• X-rays or other imaging studies to confirm the fracture type and location.
• No specific fasting or medication adjustments are typically required.

Procedure Description

1. Immobilization: The wrist and hand are immobilized using a cast, splint, or brace to ensure the broken bone stays in place during healing.
2. Pain Management: Over-the-counter pain relievers or prescribed medications may be recommended.
3. Follow-up: Periodic X-rays are taken to monitor the healing process.

No tools for surgical manipulation are used since this is a non-invasive procedure, and no anesthesia is needed.

Duration

The application of the cast or splint typically takes about 15-30 minutes.

Setting

This procedure is usually performed in an outpatient clinic, emergency room, or urgent care center.

Personnel

• Orthopedic surgeon or physician
• Nurses or medical assistants

Risks and Complications

• Skin irritation or pressure sores from the cast or splint.
• Delayed bone healing or nonunion.
• Stiffness or reduced wrist mobility.

Benefits

• Non-invasive treatment with minimal risk.
• Stabilization of the fracture for proper healing.
• Generally quicker recovery time compared to surgical options.

Recovery

• Keep the cast or splint dry and clean.
• Follow prescribed guidelines for activity restriction.
• Typically, recovery time is about 6-8 weeks.
• Regular follow-up appointments to monitor progress.
• Physical therapy may be recommended post-healing.

Alternatives

• Open reduction and internal fixation (surgical intervention).
• Closed reduction with manipulation (if bone realignment is necessary).

• Use of functional braces or splints.

  Pros and cons:

  • Surgical options may offer quicker stabilization but come with higher risks and longer recovery times.

Patient Experience

• Some initial discomfort from immobilization but generally relieved quickly with pain management.
• Limited use of the wrist and hand while the bone heals.
• Gradual return to normal activities as healing progresses and under medical guidance.

Pain during the procedure is typically minimal. Measures to ensure comfort include proper fitting of the immobilization device and pain management medication if needed.