Name of the Procedure:

Percutaneous Skeletal Fixation of Carpometacarpal Fracture Dislocation, Thumb (Bennett Fracture) with Manipulation

Summary

This procedure involves repositioning and stabilizing a dislocated fracture at the base of the thumb using minimally invasive techniques. A Bennett fracture-dislocation specifically affects the carpometacarpal joint of the thumb, requiring both realignment of the bone and stabilization to ensure proper healing.

Purpose

The procedure addresses a Bennett fracture, a dislocation of the thumb's carpometacarpal joint. The goal is to realign the bone fragments and stabilize the joint to restore normal function and prevent long-term complications such as arthritis or loss of thumb mobility.

Indications

• Dislocation of the thumb joint (Bennett fracture)
• Severe swelling and pain in the thumb
• Inability to move or use the thumb effectively
• Visible deformity at the base of the thumb

Preparation

• Patients may need to fast for 6-8 hours before the procedure if general anesthesia will be used.
• Adjustments to existing medications should be discussed with the healthcare provider.
• Pre-procedure imaging tests such as X-rays are required to assess the extent of the fracture.

Procedure Description

1. Anesthesia is administered, which could be local or general, depending on the case.
2. The surgeon makes a small incision near the base of the thumb.
3. Using fluoroscopy (a type of live X-ray), the surgeon manipulates the bone fragments into their proper positions.
4. Percutaneous pins or screws are inserted through the skin and into the bone to hold the fragments in place.
5. The incision is usually closed with a small suture or bandage.

Duration

The procedure typically takes around 30 minutes to 1 hour.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist

Risks and Complications

• Infection at the surgical site
• Damage to surrounding nerves or blood vessels
• Incomplete healing or improper alignment of bone fragments
• Potential for future arthritis or loss of thumb function
• Possible need for additional surgery

Benefits

• Proper alignment and stabilization of the thumb joint
• Restoration of thumb function and mobility
• Reduced risk of long-term complications, such as arthritis

Recovery

• Patients are often discharged the same day.
• The thumb may be immobilized in a splint or cast for several weeks.
• Physical therapy may be recommended to restore strength and mobility.
• Follow-up appointments are necessary to monitor healing.
• Full recovery can range from several weeks to a few months depending on the patient's condition and adherence to post-care advice.

Alternatives

• Closed reduction and casting (less invasive but may not provide as stable fixation)
• Open surgical repair (more invasive with potential for better visualization and alignment)
• Conservative management with splinting (limits movement but may not fully heal the fracture)

Patient Experience

• During the procedure, the patient will be under anesthesia and should not feel pain.
• After the procedure, some discomfort and swelling are expected; pain medication will be prescribed to manage this.
• The patient might experience limited thumb movement initially but should regain function gradually with proper rehabilitation.

This markdown text should provide a comprehensive overview of the procedure suitable for patient information or educational purposes.