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Closed treatment of metacarpal fracture, single; without manipulation, each bone

CPT4 code

Name of the Procedure:

Closed Treatment of Metacarpal Fracture, Single; Without Manipulation, Each Bone

Summary

This procedure is a non-surgical treatment for a broken metacarpal bone (one of the bones in the hand). It involves immobilizing the bone so it can heal on its own without needing to manually align (manipulate) the bone fragments.

Purpose

The purpose of this procedure is to treat a fractured metacarpal bone in the hand. The goal is to allow the bone to heal naturally in a stable and proper position, relieving pain and restoring function to the hand.

Indications

  • Pain, swelling, and bruising in the hand after an injury
  • X-rays confirming a metacarpal fracture
  • No need for bone manipulation to achieve proper alignment
  • Patients who can follow immobilization protocols

Preparation

  • A medical examination and X-ray to diagnose the fracture
  • The patient may be advised to keep the hand elevated and apply the ice before the procedure
  • Pain relief medication may be given

Procedure Description

  1. The patient’s hand is examined and X-rays are reviewed to confirm no manipulation is needed.
  2. A cast, splint, or brace is applied to immobilize the hand and protect the fracture.
  3. Instructions are given on how to care for the cast/splint and hand.

Duration

The procedure typically takes 30 minutes to an hour.

Setting

This procedure is commonly performed in an outpatient clinic or a hospital emergency room.

Personnel

  • Orthopedic surgeon or emergency room physician
  • Nurse or medical assistant

Risks and Complications

  • Mild discomfort from the cast or splint
  • Risk of the bone healing improperly if not immobilized correctly
  • Potential for swelling or skin irritation under the cast
  • Rarely, complications like non-union or malunion of the bone, requiring further treatment

Benefits

  • Relief from pain and stabilization of the fracture
  • Avoidance of surgery and associated risks
  • Improved healing and restoration of hand function

Recovery

  • The patient is generally advised to keep the hand elevated and avoid using it.
  • Regular follow-up appointments for X-rays to monitor healing.
  • Cast or splint typically worn for 4-6 weeks.
  • Physical therapy may be recommended after the cast is removed to regain strength and mobility.

Alternatives

  • Open treatment (surgical intervention) if manipulation is necessary or if the fracture is more complex.
  • Use of bone stimulators to enhance bone healing.
  • Pros and cons depend on the specific case - surgical options might offer better alignment but come with inherent surgical risks.

Patient Experience

  • The procedure is relatively quick and typically not painful.
  • The patient may experience some discomfort from immobilization.
  • Pain management includes over-the-counter pain relievers.
  • It’s crucial for the patient to follow care instructions and attend follow-up appointments for optimal recovery.

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